Who Policy Guidance On Integrated Antimicrobial Stewardship Activities

The WHO Policy Guidance on Integrated Antimicrobial Stewardship Activities was developed after global consultations and is anchored in public health guiding principles in the human health sector.

In 2015 the World Health Assembly endorsed the Global action plan on antimicrobial resistance calling on countries to develop and implement national action plans on antimicrobial resistance (AMR). For most countries, the greatest challenge is not developing a national action plan; rather, it is the implementation of the plan based on evidence-based prioritization of activities, systematic monitoring of progress, and ensuring sustainability of efforts. The purpose of this publication is to to provide a practical, stepwise approach to the implementation of the national action plan on AMR within the human health sector; and to provide a process and collation of existing WHO tools to prioritize, cost, implement, monitor and evaluate national action plan activities. The target audience of the publication are national/subnational stakeholders working on AMR within the human health sector. This includes national health authorities, national multisectoral coordination groups, senior technical experts and policymakers involved in implementing AMR activities at all levels of the health system, and implementation partners to accelerate sustainable implementation and monitoring and evaluation of national action plans on AMR.

Health care-associated infections (HAI) are one of the most common adverse events in care delivery and a major public health problem with an impact on morbidity, mortality and quality of life. At any one time, up to 7% of patients in developed and 10% in developing countries will acquire at least one HAI. These infections also present a significant economic burden at the societal level. However, a large percentage are preventable through effective infection prevention and control (IPC) measures. These new guidelines on the core components of IPC programmes at the national and facility level will enhance the capacity of Member States to develop and implement effective technical and behaviour modifying interventions. They form a key part of WHO strategies to prevent current and future threats from infectious diseases such as Ebola, strengthen health service resilience, help combat antimicrobial resistance (AMR) and improve the overall quality of health care delivery. They are also intended to support countries in the development of their own national protocols for IPC and AMR action plans and to support health care facilities as they develop or strengthen their own approaches to IPC. These are the first international evidence-based guidelines on the core components of IPC programmes. These new WHO guidelines are applicable for any country and suitable to local adaptations, and take account of the strength of available scientific evidence, the cost and resource implications, and patient values and preferences.

The purpose of the report is to describe the status of infection prevention and control (IPC) implementation globally, to identify future direction for monitoring and evaluation of IPC, and to set the priorities for strategic implementation of IPC in light of the gaps identified.

Antimicrobial resistance (AMR) challenges the treatment of clinical infections. Despite the decline in infectious diseases mortality rates, infections are more difficult to eliminate or contain in the host, resulting in poorer outcomes to treatment, longer hospital inpatient stays, and increased mortality. Written by international experts in the field and supported by the review of the available evidence, including example case studies, Antimicrobial Stewardship provides a practical how-to guide on this growing area. Divided into three sections, the first sets the scene, looking at the key problems of antimicrobial resistance. Section two examines and identifies the key components of an antimicrobial stewardship program. Finally, the book explores specialist areas of antimicrobial stewardship ranging from antimicrobial pharmacokinetics and dynamics, to near patient testing, and infection biomarkers. Antimicrobial Stewardship will be a valuable and practical resource for infection trainees, as well as specialists from the medical, pharmacy, and nursing professions.

The National Strategy for Combating Antibiotic Resistant Bacteria, published in 2014, sets out a plan for government work to mitigate the emergence and spread of resistant bacteria. Direction on the implementation of this strategy is provided in five-year national action plans, the first covering 2015 to 2020, and the second covering 2020 to 2025. Combating Antimicrobial Resistance and Protecting the Miracle of Modern Medicine evaluates progress made against the national strategy. This report discusses ways to improve detection of resistant infections and estimate the risk to human health from environmental sources of resistance. In addition, the report considers the effect of agricultural practices on human and animal health and animal welfare and ways these practices could be improved, and advises on key drugs and diseases for which animal-specific test breakpoints are needed.