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Govender explored the following topics in this webinar:
- Case studies: Key Stewardship principles
- Establishing an antimicrobial stewardship (AMS) team
- The ripple effect – extending stewardship efforts
- Impact of poor wound care on AMR.
Steps in stewardship
- Identify if there is a stewardship opportunity.
- Who is involved and how can we effectively engage?
- Empiric therapy
- Diagnostics/labs to be ordered.
- AMS awareness
- Evidence-based guidelines
- AMS awareness
- Evidence based guidelines.
- Monitor and analyse prescription habits
- Engage and share findings
- Share evidence-based guidelines
- Continuous audit and feedback
- Educate and share information
There is no single template for an antibiotic stewardship programme that leads to optimal antibiotic prescribing. Programmes are expected to be customised due to the complex medical decision-making surrounding antibiotic use and the differences in hospital size and care.
However, no matter what each hospital’s approach looks like, an effective antibiotic stewardship programme is always attainable with the right mix of support, leadership, and commitment.
Current challenges that hinder delivery of effective stewardship
Institution/facility with established AMS committee:
- Push back from prescribers or unwillingness to change/adhere
- Lack of commitment from members of the team
- Unrecognised outcomes
- Unrecognised efforts
- Poor infection control practices
- Stewardship fatigue.
Institution/facility without an AMS committee:
- Not recognised as a priority
- lack of resources: staffing, trained/qualified individuals
- Lack of health information technology.
AMS in a nutshell
- Identify/prioritise issues that are or have the potential to contribute to the development of resistance
- Decide on the approach – tailor/ individualise
- Audit and feedback
- Share information/education
Antimicrobial stewardship is a huge responsibility taken on by a select few who choose to fight and continue fighting for a cause often unseen.