The Aged Care Quality and Safety Commission is committed to guiding the aged care sector in the implementation of antimicrobial stewardship programs which form a major part of the global push to address the serious and ongoing issue of antimicrobial resistance. 

Antimicrobials - including antibiotics, antivirals, antifungals and antiparasitics - are medicines used to prevent and treat infections in humans, animals, and plants. However, many microorganisms (also called bugs or germs) have developed antimicrobial resistance (AMR), which means that many antimicrobials have become less effective, and infections harder to treat. These microorganisms are often referred to as “superbugs.”

Antimicrobial stewardship (AMS) includes the range of activities that promote and support optimal antimicrobial prescribing and use. The aim of the Commission’s work on AMS is to improve the safe and appropriate use of antimicrobials, reduce patient harm, and contain AMR related infections in aged care services.

A weapon in the fight - AMS self-assessment tool

AMS programs have been shown to decrease inappropriate antimicrobial usage, improve patient/resident outcomes, and reduce adverse consequence of antimicrobial use (including AMR, toxicity, and unnecessary costs).

To prompt and help providers and clinicians to review the programs and AMS activities being implemented in their service(s), the Commission has developed, and recently published, an AMS Self-assessment tool and accompanying user guide.

Using the AMS tool is optional for providers and clinicians. However, it is highly recommended to highlight the range of activities available for implementing AMS programs, help in conducting reviews of existing AMS programs, and for gaining greater understanding of what AMS involves.

The rise of superbugs - antimicrobial resistance

AMR occurs when microorganisms change or become resistant in response to antimicrobial medicines which once would have killed them. This decrease in efficacy or potency of antimicrobial medicines makes common infections harder to treat and increases the risk of disease spread, severe illness and death. 

AMR is regarded by the World Health Organization as one of the most serious public health problems of the 21st century, particularly as it pertains to antibiotic resistance in bacteria.

Although a universal concern, AMR poses a particular threat to older adults, who are more susceptible to infections owing to age-related compromised immune systems, higher rates of comorbidities, and greater exposure to “superbugs” via hospital admissions or residential living.

Results from consecutive Aged Care National Antimicrobial Prescribing Surveys and the final report of the Royal Commission into Aged Care Quality and Safety point to concerning, ongoing levels of inappropriate antimicrobial use in Australian residential aged care services. Inappropriate antimicrobial use can contribute to antimicrobial resistance.

The Commission is working with the sector to provide information and guidance on mitigating this risk to older Australians via our continually updated antimicrobial stewardship resources. 

The superhero - antimicrobial stewardship

The draft strengthened Quality Standards defines AMS as an on-going effort by a provider and clinicians to reduce the risks associated with increasing antimicrobial resistance and to extend the effectiveness of antimicrobial treatments. It can include a broad range of strategies, such as monitoring and reviewing how antimicrobials are used. 

Together with infection prevention and control, hand hygiene and surveillance, antimicrobial stewardship is considered a key strategy in local, national, and global programs to prevent the continued emergence of AMR and to decrease preventable healthcare associated infection.