What is antimicrobial stewardship?

Posted on 18 November 2022

Mediclinic takes a direct, team-led approach to fight the spread of antimicrobial resistant organisms. This programme is known as Antimicrobial Stewardship. Andriette van Jaarsveld, Clinical Pharmacy Specialist: Mediclinic SA.

In the hospital environment we talk about antimicrobials, which is the collective term for antibiotic or antibacterial, antifungal and antiviral medication.

Antimicrobial resistance poses an urgent and immediate threat to your health. The World Health Organization declared Antimicrobial Resistance as one of the top 10 global health threats facing humanity.  Organisms such as bacteria and funguses that have become resistant to antimicrobials can cause illnesses and dangerous infections to become untreatable by modern medicine. This is why Mediclinic hospitals host comprehensive antimicrobial stewardship (AMS) programmes that are designed to limit the spread of these antimicrobial resistant organisms.

The key: prescribing antimicrobials appropriately, and using them correctly.

Bacteria occur naturally in the body. Some of them are necessary, especially those present in the intestines. Others are more harmful, causing dangerous illnesses. Antibiotics are effective medications that treat these harmful bacterial infections, preventing the disease from spreading and reducing the onset of potentially serious complications.

Over time, these bacteria naturally develop resistance to some medications. However, misuse and overuse of antibiotics speed up and complicate that process – leading to bacteria that can no longer be treated with antibiotics. This puts both patients and effectiveness of antibiotics at risk, explains Andriette van Jaarsveld, Clinical Pharmacy Specialist: Mediclinic SA.

The SA Department of Health defines antimicrobial stewardship as a multidisciplinary, systematic approach to optimising the appropriate use of antimicrobials to improve patient outcomes and limit the emergence of resistant pathogens, while ensuring patient safety.

“In other words,” says van Jaarsveld, “we take a team approach to ensure that we use the currently available antimicrobials in the best possible way. The aim is to ensure patients receive the optimal treatment today – and to limit the development of resistance to antimicrobials in order to preserve these drugs for the treatment of future patients.”

A typical multidisciplinary, in-hospital AMS team at Mediclinic consists of a doctor, pharmacist, infection prevention and control manager and other nursing professionals. Where available, we include microbiologists and infectious diseases specialists, too. This team supports the optimal use of antimicrobials by conducting weekly rounds where they evaluate patient treatment plans and implement quality improvement projects to optimise antimicrobial use.”

These teams monitor and measure how antimicrobial medications are used in the hospital, and utilise evidence-based international, local and Mediclinic-specific policies and guidelines to support healthcare practitioners in using them optimally.

Antibiotics are important, life-saving medications that should only be used when needed, says van Jaarsveld. “All antibiotic use increases the development of antibiotic resistance, but the frequent use and inappropriate use increases the pressure on our available antibiotics unnecessarily.”

There are critical steps all patients can take to help ensure antibiotics remain effective:

• Ask your healthcare professional if there are steps you can take to feel better and get symptomatic relief without using antibiotics
• Never pressure your healthcare practitioner to prescribe an for you
• Take the prescribed antibiotic exactly as your healthcare professional tells you
• Bring any leftover antibiotics back to your Mediclinic pharmacy to discard safely, never save them for the next time you get sick
• Never skip an antibiotic dose
• Never take an antibiotic for a viral infection, such as a cold or the flu
• Never take antibiotics prescribed for someone else
• Ask your healthcare professional about vaccines recommended for you and your family to prevent infections that may require an antibiotic

Antimicrobial utilisation is a key clinical focus areas and a key performance indicator for all Mediclinic facilities, says van Jaarsveld.

“The AMS programmes at Mediclinic hospitals aim to treat the patient optimally with the fewest possible side-effects,” she says. “These programmes have been shown to reduce mortality due to infections and reserve treatment options, by preserving the effectiveness of antimicrobials, for future patients.”

You can read more about Antimicrobial resistance here.