QUAH - Quality Use of Antimicrobials in Healthcare

Quality Use of Antimicrobials in Healthcare is the antimicrobial stewardship (AMS) program at the Clinical Excellence Commission (CEC). The program aims to facilitate and support AMS initiatives in NSW public health facilities, in line with the recommendations of the Australian Commission on Safety and Quality in Health Care.

Key benefits of effective antimicrobial stewardship programs include:

  • improved patient care
  • optimised use of antimicrobials
  • reduced risk of adverse consequences associated with antimicrobials, including the development of antimicrobial resistance.
QUAH - Quality Use of Antimicrobials in Healthcare


Antimicrobial stewardship is the term used to describe the activities and strategies used in health care facilities such as hospitals, to improve antimicrobial use (MacDougall & Polk, 2005). In this context, the term 'antimicrobials' refers to all anti-infective agents including antibiotics, antifungals and antivirals.1

Antimicrobial stewardship programs improve quality use of antimicrobials. This means:

  • Using antimicrobials only when needed - avoiding use where there is no evidence of benefit
  • Selecting antimicrobials wisely - using narrow spectrum therapy where possible, keeping broader-spectrums agents in reserve
  • Using safe and effective doses - using correct doses and limiting duration to what is needed according to evidence.

The CEC works with NSW local health districts and networks to facilitate and support:

  • Use of clinical guidelines consistent with Therapeutic Guidelines: Antibiotic
  • Use of formulary restriction and approval systems for antimicrobials
  • Monitoring and feedback on antimicrobial prescribing
  • Provision of information by clinical microbiology laboratories to guide quality use of antimicrobials.

AMS Expert Advisory Committee

The CEC AMS Expert Advisory Committee is a multidisciplinary panel which provides expert advice and strategic direction to the QUAH program. Membership consists of representatives across NSW local health districts and specialty health networks, with additional appointments for key stakeholder groups and specialties.


  1. Duguid M, Cruickshank M (eds). Antimicrobial stewardship in Australian Hospitals. Australian Commission on Safety and Quality in Health Care, Sydney; 2010. http://www.safetyandquality.gov.au/our-work/healthcare-associated-infection/antimicrobial-stewardship/book/
  2. MacDougall C, Polk RE. Antimicrobial stewardship programs in health care systems. Clin Microbiol Rev. 2005 Oct;18(4):638-56.