Table 5 Potential areas of focus for antimicrobial stewardship interventions as proposed by study participants

Nursing staff education and training

-Reinforcement of issues about antibiotic use, antibiotic resistance and benefits of antimicrobial stewardship

-Education sessions as part of in-service training, via online training modules, awareness campaigns, etc.

Aged care-specific infection management algorithms for nursing staff

-Flow charts to guide appropriate initial testing of residents, as well as guidance with regard to conditions that may be observed versus those requiring immediate contacting of prescribers

-Targeted management of common infections, in particular, urinary and respiratory tract infections

Aged care-specific antibiotic treatment guidelines

-Development of evidence-based aged care antibiotic treatment guidelines (with recommendations about appropriate dosages and duration of therapy)

-Education to prescribers through online updates or distribution of newsletters, highlighting evidence-based prescribing practices

Regular surveillance of antibiotic use by consultant pharmacists

-Passive surveillance and audit of antibiotic use, with regular feedback to the prescribers

-Documentation of individual residents’ prior antibiotic exposure over time, supplemented by antibiotic susceptibility results to guide prescribing decisions

Improved communication about decisions related to antibiotic prescribing

-Early discussion with residents and/or families about antibiotic use during acute events and terminal illness as part of advanced care planning

-Proper handover from locum doctors to regular GPs regarding antibiotics prescribed after hours for further review

-Faxing of treatment plans for phone ordering of antibiotics via antibiotic ordering form with clear indications for treatment and planned duration of treatment