AMS Flashcards
(28 cards)
What is Antimicrobial Stewardship (AMS)?
AMS is a healthcare system-wide approach to promote and monitor the judicious use of antimicrobials to preserve their future effectiveness.
How does BSAC define AMS?
Optimal selection, dosage, and duration of antimicrobial treatment for best clinical outcome with minimal toxicity and resistance.
What are the core goals of AMS?
Improve patient outcomes, improve safety (e.g., reduce C. difficile), reduce resistance, and reduce healthcare costs.
What is Antimicrobial Resistance (AMR)?
Loss of effectiveness of anti-infective medicines including antivirals, antifungals, antibacterials, and antiparasitics.
Why is AMR a problem?
AMR has risen over decades while few new antimicrobials are developed; inappropriate use of broad-spectrum antibiotics fuels resistance.
What is the ‘Start Smart Then Focus’ (SSTF) toolkit?
An evidence-based framework for AMS in secondary care focusing on judicious antimicrobial initiation and 48–72 hour review.
What are the steps in SSTF?
Start smart: only use antimicrobials if needed; then focus: review at 48–72 hours based on MC&S results.
What are the 5 review outcomes in SSTF?
Stop, Switch (IV to oral), Amend (spectrum), Extend (with review/stop date), Refer (e.g., OPAT).
What is a soft stop in antibiotic prescribing?
A system prompt to review antibiotics at 48–72 hours.
What is a hard stop in antibiotic prescribing?
Automatic stop of empiric antibiotics after a set time unless actively reviewed and renewed.
What is the TARGET toolkit?
Treat Antibiotics Responsibly, Guidance, Education and Tools – a primary care AMS toolkit.
Who developed the TARGET toolkit?
UKHSA, RCGP, and ASPIC Group.
What are hospital pharmacists’ roles in AMS?
Governance, leading AMS, advising on regimens, contributing to audits, reviewing prescriptions, and more.
What is OPAT?
Outpatient Parenteral Antibiotic Therapy – enables IV antibiotics outside hospital.
What are community pharmacists’ AMS roles?
Screen prescriptions, deliver NHS services, provide education, do simple diagnostics, and identify alarm symptoms.
What are GP pharmacists’ AMS roles?
Diagnose and treat, advise on evidence-based prescribing, maintain accurate records, and perform audits.
What roles do pharmacists in academia and industry play?
Educate future pharmacists, develop new drugs, publish research, and influence policy.
Why do pharmaceutical companies invest less in antimicrobials?
They are less profitable due to short treatment courses and rising resistance.
What is the financial incentive challenge in AMS?
NHS incentivises reduced use, but discontinuation at 48–72 hours is rare.
Why is patient pressure a challenge for AMS?
Patients expect antibiotics even when not appropriate, leading to overprescribing.
What is MC&S?
Microscopy, Culture and Sensitivity – lab tests to identify pathogens and appropriate treatments.
When should antimicrobial prescriptions be reviewed?
At 48–72 hours post-initiation in inpatient settings per SSTF.
Why is IV to oral switch important?
Reduces complications, improves discharge times, and is cost-effective.
Why is it critical to document indication and review date?
To ensure clarity, safety, and compliance with AMS protocols.
