Objective two of the recently released strategy focuses on implementation of effective antimicrobial stewardship across all sectors of human health.

The 2013 National Antimicrobial Prescribing Survey deemed 30% of hospital antimicrobial prescriptions were inappropriate although it was hard to tell because only 71% had a reason for prescription documented in the medical notes. Inappropriate antimicrobial use is also highly prevalent in Australian residential aged care facilities. Antimicrobial stewardship (AMS) programs aim to avoid unnecessary antimicrobial use, optimise care of patients with infection and reduce adverse events due to antimicrobials.

Priority areas to meet this objective include:

• Ensure availability of tailored, evidence-based guidelines  across all health and veterinary sectors
• Ensure availability of evidence-based, best-practice,  consistent approaches to AMS
• Develop evidence-based resources to support the implementation of AMS programs
• Review existing accreditation and quality assurance programmes to ensure they support and encourage compliance with best practice AMS
• Strengthen measures that are already in place

Hunter New England Local Health District (HNE) intends to:

• Revise local AMS governance arrangements to more clearly define responsibilities for AMS programs
• Improve access to national and local guidelines – Pathology North clinical guideline reference page
• Adopt current Clinical Excellence Commission classifications for restricted antimicrobials
• Develop new AMS approaches in collaboration with rural GP practices and HNE GP-VMOs
• Expand the range district wide AMS indicators that help services to measure how well they are doing