11 Summary

In this course you have learned about the importance of AMS structures, and the strategies needed to implement AMS at a national and hospital level. AMS programmes are multidisciplinary initiatives that should be integrated into all areas of healthcare; but, because AMR is a global problem, stewardship should be extended to diverse areas including veterinary and agricultural AMU, in line with the One Health approach.

AMS evolves over time in a cycle of measurement, feedback and change, which allows it to adapt quickly in the ongoing fight against bacterial pathogens and the development of AMR. By investing in AMS – whether starting from nothing or building on an existing programme – a hospital may improve patient care and outcomes, save money and reduce the development of AMR.

While this course has explained how AMS can involve resources such as integrated IT systems and modern laboratory testing techniques, these resources are not available everywhere; in low-resource settings, small steps towards AMS can still result in significant benefits. Essentially, it must be underpinned by effective collaboration and communication between clinical, laboratory and pharmacy staff, and managed as an essential activity, with education and training.

You should now be able to:

• understand the principles of an AMS programme
• understand how to approach setting up an AMS committee
• indicate the place of the laboratory in the AMS process
• develop local prescribing guidelines
• describe AMS strategies such as prospective audit and feedback
• understand quantitative and qualitative ways to assess antimicrobial consumption and use
• appreciate the importance of understanding the pharmacokinetics and pharmacodynamics of antimicrobials in determining the optimum treatment strategy
• appreciate that AMS can be introduced gradually, and that initial emphasis on easier-to-achieve targets can lead to significant improvements
• refer to treatment guidelines and resources (such as WHO courses)
• describe the costs and benefits (cost-effectiveness) of implementing AMS.

Now that you have completed this course, consider the following questions:

• What is the single most important lesson that you have taken away from this course?
• How relevant is it to your work?
• Can you suggest ways in which this new knowledge can benefit your practice?

When you have reflected on these, go to your reflective blog [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)]   and note down your thoughts.