The Impact of the Implementation of the Antimicrobial Stewardship Program in a Victorian Regional Hospital

Mr Clement Oguche1

1Northeast Health Wangaratta, Wangaratta, Australia


Background: Antimicrobial resistance is one of the biggest challenges of modern healthcare in terms of cost and health outcomes. Implementation of  Antimicrobial Stewardship Programs (AMS) have been shown to improve the appropriate and rational use of antimicrobial agents. However, due to workforce constraints, many  rural and regional hospitals are not able to fully implement the program.

Aim: To determine whether the AMS program undertaken at a regional hospital has achieved its goal of improving compliance with therapeutic guidelines and reduced use of restricted antimicrobial agents.

Setting: 200-bed Regional hospital with an AMS team comprising of Infection control and  prevention nurse and 2 pharmacists.

Methods: A  descriptive observational study using retrospective medical file data  before and after implementation of the AMS program.

Outcome parameters included compliance with guidelines, appropriateness, approval status, microbiology culture mismatch, volume of antimicrobial agents used. These outcomes were compared for different time periods : pre-intervention and post- intervention.

Results: Ninety-two prescribing episodes were captured over the study period.  There were significant improvements in six of the seven measured outcomes. Eighty two per cent of the prescribing episodes were concordant with therapeutic guidelines post intervention compared to 51% pre-intervention. Similar results were seen with appropriateness (77.6% post intervention vs 23.3% pre-intervention) ; documented indication (80% vs 79.1%), microbiology culture (95.9% post-intervention compared to 51.2% pre-intervention); approval given by the specialist prior to prescribing (Post intervention 83.7% vs 28% pre-intervention).

Conclusion:The implementation of the antimicrobial stewardship program  in a regional hospital has significantly improved antimicrobial prescribing practice.


I am a hospital pharmacist with a special interest in antimicrobial use and treatment of infections. Been a pharmacist in Australia for the past 8 years.The research was conducted as part of an award for  masters in clinical pharmacy.

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