Antimicrobial stewardship (AMS) in the community setting
Most antimicrobial use occurs in the community setting, so general practice is an important focus for antimicrobial stewardship (AMS).
Community-based practitioners can use many strategies to optimise antimicrobial prescribing. Efforts to avoid antibiotic use for infections when the likelihood of benefit is low (eg upper respiratory tract infections), or selection of narrow-spectrum antimicrobials rather than broad-spectrum antimicrobials (where possible), can have a major impact on population-wide antimicrobial consumption.
Community-based practitioners can have a positive influence on the beliefs of individual patients and the broader community about antimicrobial use and resistance. For patient resources, see Antimicrobial stewardship (AMS) resources for patients.
The Australian Commission on Safety and Quality in Health Care (ACSQHC) is developing AMS strategies for general practice, including strategies for Primary Health Networks, general practitioners and other staff – for examples, see Antimicrobial stewardship strategies for general practice.
Component of general practice | Strategies for antimicrobial stewardship (AMS) |
Primary Health Networks | Promote Antibiotic Awareness Week Establish a local AMS advisory group Promote AMS through education, information resources and tools for schools, childcare centres and community groups |
General practice owners | Promote the Australian Antimicrobial Stewardship Clinical Care Standard produced by the Australian Commission on Safety and Quality in Health Care Provide staff with access to Therapeutic Guidelines: Antibiotic Encourage participation in audits about antimicrobial prescribing at a practice level |
General practitioners | Participate in online learning modules on AMS Demonstrate commitment to antimicrobial stewardship using a ‘commitment poster’ Prescribe according to Therapeutic Guidelines: Antibiotic Configure clinical software to default to zero repeats for antimicrobials Specify the duration of antimicrobial therapy on the prescription Take a thorough allergy history prior to documenting an antimicrobial allergy (see Clinical history for initial assessment of patients reporting antimicrobial hypersensitivity) Use shared decision making with consumers for antimicrobial decisions, when appropriate Use delayed antimicrobial prescriptions in selective situations for management of upper respiratory tract infections Participate in audit and feedback activities for prescribing of antimicrobials Discuss infection prevention strategies (eg vaccination, optimal foot care for patients with diabetes) |
General practice staff | Implement infection control and prevention strategies according to national guidelines Display AMS information for consumers (eg posters, videos, pamphlets) Promote up-to-date immunisation |