Aged care laws in Australia have now changed. The Aged Care Act 2024 and Aged Care Rules 2025 now apply. We're completing updates to this page to align with the new laws. Providers are advised to refer to the new Act and Rules for any required clarification of their obligations and legal responsibilities. Thank you for your patience.
Antimicrobial stewardship (AMS) is the ongoing work providers and workers do to make sure they use antimicrobial medicines (antimicrobials) appropriately and minimise their use. Antimicrobials are medicines that kill or slow the growth of germs (bacteria, virus and fungus) that cause diseases. Antibiotics are the most commonly prescribed antimicrobial. Using antimicrobial medicines inappropriately contributes to antimicrobial resistance, which is a worldwide problem.
Aged Care National Antimicrobial Prescribing Surveys and the final report of the Royal Commission into Aged Care Quality and Safety show ongoing high levels of inappropriate antimicrobial use in residential aged care.
Infection prevention and control measures and AMS can help tackle the problem of antimicrobial resistance and reduce the likelihood of older people contracting infections.
Through our AMS work we aim to:
- improve the safe and appropriate use of antimicrobials
- reduce harm to older people
- prevent and reduce antimicrobial resistance in aged care services.
The Aged Care Quality Standards (Quality Standards):
- highlight how important AMS is (Standard 5: Clinical Care)
- require providers to encourage and support workers, health practitioners and others to use antimicrobials appropriately to reduce risks of increasing resistance (Standard 5: Clinical Care, Outcomes 5.2 and 5.3)
- require governing bodies and providers to have systems to monitor and evaluate the clinical care services they provide and make sure they follow contemporary, evidence-based practice, including appropriate use of antimicrobials (Standard 2: The Organisation and Standard 5: Clinical Care).
Providers should have an AMS system that complies with contemporary, evidence-based practice and is relevant to the service context. AMS systems help services:
- promote appropriate use of antimicrobials
- improve care for older people
- reduce the negative effects of using antimicrobials (including antimicrobial resistance, toxicity and unnecessary costs).
Resources for providers and clinicians
AMS self-assessment tool and user guide
The AMS self-assessment tool (AMS SAT) for residential aged care services helps providers develop an AMS system and assess the effectiveness of their AMS activities and how they are contributing to the overall system.
The AMS SAT User Guide can support you in using the tool.
AMS and quality improvement for aged care leaders program
The AMS and quality improvement for aged care leaders program helps providers to develop, implement and improve their AMS systems. You can find the program on Alis. Alis is free for registered providers, associated providers, their workers and responsible persons.
This program is for leaders and champions working on AMS education, training and quality improvement in residential, home and community aged care. For example:
- infection prevention and control leads
- nurses
- care managers
- quality and safety managers
- pharmacists working with aged care providers.
You can find out more about the program in our program flyer and video.
To Dip or Not to Dip
To Dip or Not to Dip (TDONTD) is a quality improvement activity to improve the way providers assess and manage urinary tract infections (UTIs). It aims to reduce antibiotic prescribing for UTIs in aged care.
Evaluation of TDONTD shows that it changes behaviour and reduces inappropriate use of antibiotics.
TDONTD key resources
These resources support TDONTD quality improvement activities in residential aged care:
- To Dip or Not to Dip implementation guide
- To Dip or Not to Dip? flyer (available in 25 languages).
- Staff case-based education presentation and facilitator guide
- Clinical pathway forms for older people with and without catheters
- Clinical pathway user guide
- To Dip or not To Dip training video for staff
- Audit tool (editable PDF document)
- Take the dipstick test survey
- A3 huddle tool poster
Supporting resources
- Do you need antibiotics? flyer (available in 25 languages)
- TDONTD project findings (summary)
- TDONTD project report
- Implementation of an intervention to reduce urine dipstick testing in aged care homes: a qualitative study of enablers and barriers, and strategies to enhance delivery (BMJ article)
- Feasibility of a nurse-led intervention to reduce urine dipstick testing in long-term residential aged care homes (JAMDA article)
Clinical Pharmacy Unit
Our Clinical Pharmacy Unit offers visits to aged care services to provide education on quality use of medicines and TDONTD. To arrange a visit to your service, email PharmacyUnit@agedcarequality.gov.au
Quality Bulletin articles and clinical alerts
- Clinical alert and advice – New report finds older Australians given more antimicrobials than wider community
- Quality improvement initiative improves antibiotic use – #47 November 2022
- Recognising the signs of sepsis early can save lives – #45 September 2022
- From the Chief Clinical Advisor – #33 September 2021
- From the Chief Clinical Advisor – #32 August 2021