Dr Rod James1
1National Centre for Antimicrobial Stewardship
Biography:
Dr Rod James is a medical microbiologist and Director of Clinical Services for the National Centre for Antimicrobial Stewardship and Royal Melbourne Hospital Guidance Group at the Doherty Institute, Melbourne, and co-leads the Institute’s Antimicrobial Resistance Theme. Rod leads the National Antimicrobial Prescribing Surveillance program and has extensive experience in antimicrobial stewardship, antimicrobial resistance, infection prevention and control, surveillance and digital health. His work spans clinical practice, research, policy and implementation, with national and international collaborations, particularly in resource poor settings, focused on translating surveillance and evidence into practical improvements in antimicrobial use and patient care.
Abstract:
Antimicrobial resistance is an escalating threat to human, animal and environmental health, requiring antimicrobial stewardship (AMS) to extend beyond traditional hospital-based programmes. This presentation explores the evolving evidence for effective AMS across hospital, aged care, primary care and animal health settings, while considering the wider clinical, economic, behavioural and environmental drivers of antimicrobial use.
Effective stewardship requires a combination of structural foundations, including policy, leadership, multidisciplinary expertise and education, alongside interventions such as guidelines, decision support, audit and feedback, prescribing restrictions and post-prescription review. However, the strength of evidence varies markedly between interventions and settings, with substantially greater evidence available from hospitals than community, aged care and animal health. No individual intervention is consistently superior, reinforcing the importance of multifaceted, context-specific approaches.
The presentation will also consider how success is measured. Although antimicrobial consumption remains widely used, quantity alone cannot determine whether prescribing is appropriate. Effective surveillance should increasingly assess prescribing quality and appropriateness while recognising patient safety, infection prevention and control, equity, resource constraints and local antimicrobial resistance epidemiology. Ultimately, sustainable AMS requires adaptable interventions embedded within broader One Health systems.