Antimicrobial stewardship

Antimicrobial stewardship (AMS) is defined as the ongoing effort by a provider (and clinical caregivers) to optimise and minimise the use of antimicrobial medicines. Inappropriate antimicrobial use contributes to antimicrobial resistance, which has become a widespread, global problem.

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

Effective infection prevention and control (IPC) measures and AMS interventions improve infectious disease outcomes and help address the problem of antimicrobial resistance.

The Commission’s focus on AMS

The draft strengthened Quality Standards define AMS as an on-going effort by a provider 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.

The aim of the Commission’s antimicrobial stewardship work is to:

  • improve the safe and appropriate use of antimicrobials
  • reduce resident harm
  • prevent and contain antimicrobial resistance in aged care services

Quality Bulletin

Support tools and resources for providers and clinicians

AMS Self-assessment tool and user guide

The Commission has developed the Residential Aged Care Services tool (AMS SAT) to help providers/clinicians to review the AMS activities they have undertaken and their contribution towards a comprehensive AMS program being implemented in their service(s).

The AMS SAT User Guide is also provided as an important resource to be used in conjunction with the tool.

To Dip or Not to Dip

To Dip or Not to Dip (TDONTD) is a quality improvement intervention to improve management of urinary tract infection (UTI) and aims to reduce antibiotic prescribing for UTIs in aged care.

Evaluation of TDONTD shows that it is effective in changing behaviour and reducing inappropriate antibiotic use. See:

These are the key resources designed to enable delivery of the TDONTD quality improvement intervention in aged care:

TDONTD resources – to support best outcomes:

Resources to support use of TDONTD audit data

  • TDONTD audit: How to perform, analyse and use the audit results (this resource is coming in 2024).

Resources to promote TDONTD:

The Commission’s Clinical Pharmacy Unit

  • The Commission’s Clinical Pharmacy Unit offers visits to aged care services to provide education on medications and TDONTD. If interested in arranging a visit to your service, email PharmacyUnit@agedcarequality.gov.au.

For further resources on antimicrobial resources for clinicians and consumers

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Acknowledgement of Country

In the spirit of reconciliation, the Aged Care Quality and Safety Commission acknowledges the Traditional Custodians of Country throughout Australia and their connections to land, water and community. We pay our respect to their Elders, past, present and emerging and extend that respect to all Aboriginal and Torres Strait Islander peoples.