Antimicrobial stewardship (AMS)

Antibiotic stewardship can be defined as “co-ordinated interventions designed to improve and measure the appropriate use of antibiotic agents by promoting the selection of the optimal antibiotic drug regimen, including dosing, duration of therapy and route of administration.”

Antimicrobial stewardship (AMS) follows the same principles as antibiotic stewardship, except that AMS includes antibiotics, antifungals, anti-virals and anti-parasitic drugs.

Sir Alexander Fleming, who discovered penicillin in 1928, once said: “The thoughtless person playing with penicillin treatment is morally responsible for the death of the man who succumbs to infection with the penicillin-resistant organism.”

Antimicrobials have changed the face of modern medicine. Lethal infections became treatable with miracle drugs in the antibiotic era, but it was found that in 20 to 50% of cases, antimicrobial prescribing was unnecessary or inappropriate. The misuse of antimicrobials led to one of the most serious public health threats of our time, contributing to antimicrobial resistance.

What makes antimicrobials different to any other medication is that their misuse can have an impact on patients who are not even exposed to them, due to their potential for contributing to the spread of resistant organisms.

AMS programmes have proved internationally that by improving antimicrobial use, treatment of infections can be optimised, adverse events can be reduced, and antimicrobial resistance can be reduced. These programmes assist clinicians with improving quality patient care and safety. Treatment failures can be reduced, infection cure rates can be increased and appropriate prescribing can occur more frequently by means of correct prescribing for therapy and prophylaxis.

Although the aim for AMS is to preserve the effectiveness of our only available antimicrobials, it also happens to contribute immensely to reducing healthcare costs.

Life Healthcare pharmacists play a key role in leading AMS programmes in our hospitals, by evaluating patient medication treatment and, in particular, their antimicrobial usage, to achieve the best possible clinical outcomes.

Our Life Healthcare pharmacists form an integral part of the multidisciplinary healthcare team, which consists of physicians, nurses, dieticians, microbiologists, and other healthcare professionals. They play a supporting role in guiding and evaluating patient medication treatment to provide the best quality care for our patients.