The Antimicrobal Stewardship Programme: where have we been...where are we going?

The misuse or overuse of antibiotics has been widely documented as one of the major causes of the emergence and transmission of multi-drug resistant organisms (MDRO). Antimicrobial resistance posed significant impacts to the increase in morbidity, mortality and cost of health care. In response to the threat of antibiotic resistance which has increased dramatically over the past ten years and the very few new antibiotics in the pipeline, Princess Margaret Hospital set up a Steering Committee with senior-level representatives from Infectious Disease, Microbiology and Pharmacy departments to devise an interventional programme called the Smart Use of Antibiotics Programme (SMAP) to offer guidance on the judicious use of antimicrobials. With concerted effort and support from hospital management and frontline clinicians, SMAP achieved significant monetary savings and a reduction in inappropriate antibiotic use. There was no adverse patient outcome in terms of mortality and morbidity