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Antimicrobial Stewardship in Australian Hospitals and Other Settings

机译：澳大利亚医院和其他环境中的抗菌素管理

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Australia’s model of antimicrobial stewardship (AMS) has evolved significantly over recent years, from a long-standing national approach of antimicrobial prescribing guidelines and antimicrobial prescribing restrictions to recent advances including the first National Antimicrobial Resistance Strategy and incorporating mandatory AMS as part of hospital accreditation standards. AMS programs are most commonly found in the hospital setting. Various models are used throughout the country based on the local context and resources available. Programs implemented at Alfred Health and the Royal Brisbane and Women’s Hospital represent two successful models in tertiary referral settings that accommodate a general ward setting as well as specialized areas with a high infection burden. Measurement of outcomes related to AMS activities remains poorly standardized, with process indicators such as antimicrobial utilization forming a large proportion of outcome measurement. Presently there is no requirement for any AMS outcome measurements to be reported externally. Point prevalence surveys of appropriateness of prescribing and compliance with prescribing guidelines are widely used at a national level. Despite this, there is still a paucity of published Australian data to support the effect of AMS on patient clinical outcomes. Private hospitals, the community, veterinary medicine and aged care sectors represent an important area for future AMS expansion within Australia. The AMS focus has traditionally been on prescribing restrictions (through the Commonwealth funding agencies); however, recent work has described other areas for improvement and development in both settings. AMS in Australia continues to evolve. The recent development of an Australian strategic plan to link antimicrobial utilization and resistance surveillance with policy represents an important step forward for the future of AMS in Australia.
机译：澳大利亚的抗菌素管理模式（AMS）近年来已发生了重大变化，从长期的国家抗菌素处方指南和抗菌素处方限制方法到最新进展，包括第一个《国家抗菌素耐药性策略》，以及将强制性AMS纳入医院认可标准的一部分。 。 AMS程序最常见于医院环境中。根据当地情况和可用资源，全国各地使用各种模型。在Alfred Health和皇家布里斯班妇女医院实施的计划代表了在三级转诊环境中的两个成功典范，既可以适应普通病房环境，又可以承受高感染负担的专门区域。与AMS活动相关的结果的衡量标准仍然差强人意，诸如抗菌素利用等过程指标在结果衡量中占很大比例。目前，不需要任何外部报告AMS结果测量。在国家一级广泛使用关于处方是否适当以及是否符合处方指南的点流行率调查。尽管如此，仍然缺乏澳大利亚公布的数据来支持AMS对患者临床结局的影响。私立医院，社区，兽医和老年护理部门是澳大利亚AMS未来扩展的重要领域。传统上，AMS的重点是规定限制（通过联邦资助机构）;但是，最近的工作描述了这两种情况下需要改进和发展的其他领域。澳大利亚的AMS不断发展。澳大利亚制定了将抗菌素利用和耐药性监测与政策联系起来的战略计划，这是澳大利亚AMS未来迈出的重要一步。

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