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An Initiative Supported by the Ontario Agency for Health Protection and Promotion and the Ontario Ministry of Health and Long-Term Care
Ontario Antimicrobial Stewardship Project
Preserving Antibiotics for Future Generations
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Antimicrobial resistance is a known major public health issue, and antimicrobial stewardship, the appropriate use of antimicrobial agents, is critical to stemming the continued emergence of antimicrobial-resistant organisms.

The increasing recognition of the health burden associated with hospital-acquired infections in Canada and the increasing evidence that the use of antimicrobials in hospitals is a critical determinant of infection rates due to the most important hospital-acquired pathogens, methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile, emphasize the urgency of developing and facilitating antimicrobial stewardship programs in Ontario hospitals.

Literature has shown that appropriate use of antimicrobials can reduce occurrences of antibiotic resistant organisms. An antimicrobial stewardship project led by ISMP Canada for the province of Ontario is another knowledge translation project that comprised of multiple phases. In the first phase, a comprehensive survey was conducted to examine the current state of hospital-based antimicrobial stewardship practices in Ontario.

In the second phase, the project team convened an international consensus forum to determine and prioritize interventions that were considered to be appropriate and effective. The following six interventions were identified (in no particular order):

  • Implement an Antimicrobial Stewardship Program at the hospital level
  • Antimicrobial Stewardship Self-Assessment Tool
  • Prospective audit with intervention and feedback at an individual patient and prescriber level
  • Education/training needed to build antimicrobial stewardship capacity
  • Data collection and feedback at an institutional or program level
  • Tailoring antimicrobial therapy including de-escalation, streamlining and IV to PO switches.

The third phase proposes testing of these interventions in a representative sample of pilot hospitals and is currently under discussion.

Past Conferences and Events
Consensus Conference on Priority Interventions for Ontario Hospitals
June 16 - 17, 2009
Toronto, Ontario
 Consensus Conference on Priority Interventions for Ontario Hospitals
Antimicrobial Stewardship Survey, 2007
 Ontario Antimicrobial Stewardship Survey Summary
External Links

Antimicrobial Stewardship

Antimicrobial Use Measurement and Coding/Classifications

Useful Links
Project Team

Allison McGeer, MSc, MD, FRCPC

Director, Infection Control
Infectious Diseases Physician, Mount Sinai Hospital, Toronto

Donna Lowe, PharmD

Drug Utilization Coordinator
University Health Network, Toronto

Linda Dresser, PharmD

Pharmacotherapy Specialist - Antimicrobial Stewardship
Universtiy Health Network, Toronto
Assistant Professor, Leslie Dan Faculty of Pharmacy
University of Toronto

Kevin Katz, MD, FRCPC

Medical Director, Infection Control and Prevention;
Infectious Diseases Physician and Medical Microbiologist
North York General Hospital, Toronto

Archie Kwan, BSc Pharm, ACPR

Drug Utilization Coordinator
The Scarborough Hospitals, Scarborough

David U, MScPhm

President and CEO
Institute for Safe Medication Practices Canada

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416-733-3131 x 226
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