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Antimicrobial Stewardship Unit (ASU)

The growing global threat

Experts predict that antibiotic resistance could lead to a death rate of 10 million people per year by 2050. This threat looms closer as a rising number of infections become increasingly difficult to treat due to the misuse and overuse of antibiotics.

Locally, a recent study found that 51% of hospitalised patients are on at least one antibiotic at any one time – not all of which are necessary. This unnecessary use of antibiotics leads to longer hospital stays and higher medical costs.

What is ASU and how does it help?

We are a multidisciplinary team of infectious diseases (ID) physicians and ID pharmacists, supported by an executive; committed to promoting responsible antibiotic use. We strive to reduce antibiotic resistance and the adverse effects of antibiotic use, while improving the quality of care in the prevention and treatment of infections.

ASU Team (From left to right)

Back row: Winnie Lee (specialist pharmacist), Lee Lai Wei (pharmacist), Tan Lun Yi (executive), Dr Piotr Chlebicki (ID senior consultant), Dr Benjamin Cherng (ID consultant), Alvin Chua (senior clinical pharmacist)

Front row: Dr Jasmine Chung (ID consultant), Dr Andrea Kwa (pharmacy clinician scientist), Loo Li Wen (senior clinical pharmacist), Sarah Tang (specialist pharmacist), Daphne Yii (pharmacist), Yvonne Zhou (senior clinical pharmacist), Liew Yixin (specialist pharmacist), Teo Bao Wen (pharmacist), Lim Fang Kang (pharmacist)

What does ASU do?

The ASU team works closely with your doctors to select the most appropriate antibiotic for your medical condition. We review prescriptions of broad-spectrum antibiotics in the hospital to ensure that they are optimally-dosed and are cost-effective, without compromising your health and safety.

In addition, the ASU team implements measures that help improve antibiotic use in the hospital such as development of hospital antibiotic guidelines, designing IT tools and conducting educational sessions for healthcare professionals. We also monitor and analyse patterns of antibiotic use and trends of bacteria resistance to identify areas of concern; improve and adapt our approaches as necessary and measure the impact of our interventions. Since 2016, we have organised activities to engage the public to raise antibiotic awareness.

Patient Education

8 interesting facts you may not have known

  1. Antibiotics only work against bacteria; they do not work against viruses or fungi.

  2. Antibiotics will not cure most coughs, colds or flus.

  3. A longer course of antibiotics does not necessarily mean it is better for your infection. It may cause more harm instead.

  4. Antibiotic resistance happens when the bacteria becomes resistant to the antibiotic; it is not our bodies that become resistant to the antibiotic.

  5. Resistance can happen after just one dose of an antibiotic.

  6. Alcohol-based hand sanitisers do not contribute to antibiotic resistance.

  7. Alcohol-based hand sanitisers are not a substitute for hand-washing with soap and water. There are some bacteria that alcohol-based hand sanitisers cannot get rid of.

  8. You can help fight antibiotic resistance:

    1. Do not ask for antibiotics if they have not been prescribed for you

    2. Take antibiotics as prescribed

    3. Do not share antibiotics, even with family members

    4. If you are on injectable antibiotics and have started eating, ask your doctors if you can switch to oral antibiotics.

Patient Education

Education

ID Pharmacotherapy Specialty Residency programme

This is a 1 year full-time clinical training programme which aims to equip inpatient pharmacists with strong competencies in the field of infectious diseases, with special emphasis in the following areas:

  • Antibiotic dose-response assessment

  • Pharmacokinetics and pharmacodynamics principles and their application in the use of antimicrobials, antifungals and antivirals

  • Pathophysiology and management of infections of common bacteria, fungi and viruses

  • Antimicrobial resistance

  • Antibiotic stewardship/control policies

  • Clinical and translational research

The programme is conducted primarily in SGH, with 3 months of external rotations to other hospitals in Singapore.

Research

The ASU team is actively involved in clinical research, including collaborations with colleagues from clinical departments, as well as other healthcare institutions in Singapore. Some of our main areas of focus are:

  • Pharmacokinetics and pharmacodynamics of antimicrobials

  • Development of antimicrobial assays for therapeutic drug monitoring

  • Molecular diagnostics of fungal diseases

  • Development of IT tools to improve antimicrobial prescribing appropriateness

  • Impact of antimicrobial stewardship programmes

  • Combination testing for multi-drug resistance organisms