Together, we can prevent antimicrobial resistance.
Antimicrobial resistance is one of the greatest threats to human and animal health. Resistance occurs when bacteria, viruses, fungi and parasites change to protect themselves from antimicrobials, which means infections that once could be treated with these medicines may become life-threatening again.
On average, one in two antibiotics prescribed in Australian hospitals are done so inappropriately.
What is Monash Health’s traffic light restriction system for antimicrobials?
Preventing antimicrobial resistance is the shared responsibility of all clinicians.
Monash Health has operated an Antimicrobial Stewardship Service since 2013. The service provides a more accurate and consistent way to ensure our patients receive the right treatment for their needs.
The Monash Health Antimicrobial Traffic Light System is an evidence-based antimicrobial restriction system which means specialised antimicrobials are reserved to prevent the rise of resistance and to ensure optimal treatment for our patients. We have a hotline staffed by doctors specialising in infectious diseases which can be called for approval.
Earlier this year, some changes to the antimicrobial traffic light system came into effect.
What’s changed?
Recent changes to the traffic light restriction system include:
- 5pm closure of the hotline (previously 8pm)
- Some antimicrobials have changed category
- Additions to, and time limits introduced for some, orange indications
- Addition of a new category ‘Red Starred’ antimicrobials – these antimicrobials are highly-specialised medications so require ID approval 24 hours, 7 days a week (approval can be obtained after hours by contacting on-call ID registrar)
- Addition of Baret messaging to enable increased communication and timely responses (during hotline hours)
Protect our antibiotics
These changes have been brought in:
To enable more oversight of our specialised antimicrobials, ensuring they are reserved to prevent the rise of resistance and to provide optimal treatment for your patients.
To improve timely access to other antimicrobials for evidence-based indications.
Check the traffic light restrictions before:
- Prescribing
- Administering, or
- Supplying
Prescribing a restricted antibiotic?
Call the approvals hotline every day 8am to 5pm, 7 days a week
Baret or Ext 3725 (ESBL)
An ID registrar or consultant is on the approvals hotline every day from 8am to 5pm.
STOP
Between 8am-5pm every day, any RED classified antimicrobial medication requires ID approval before use.
Red starred antimicrobial medications require ID approval at all times, including outside of ID approval hotline hours.
CHECK
Between 8am-5pm every day, all ORANGE classified antimicrobial medications are pre-approved only for specific indications outlined in the Antimicrobial Stewardship Service guidelines.
Indication not listed? Contact the Approvals Hotline.
GO
Green classified antimicrobial medications can be used at any time without restriction.
The system applies from 8am-5pm (including weekends).
All antimicrobial medications are assigned to a certain classification.
Certain medications will require ID approval before they can be prescribed to a patient.
Approval can be obtained through Baret: during the week, this is the All Sites ID antibiotic approvals role, and on the weekends, it is the All Sites ID after-hours on-call role. If after-hours approval is required for a red starred antimicrobial, contact the ID reg on call.
Whenever you review or supply an antimicrobial, check the Antimicrobial Traffic Light tool to see if you should stop, check or go.
Where can I find out more?
The Antimicrobial Traffic Light Tools and Procedures (adults and paediatrics) have been updated.
Antimicrobial Traffic Lights (Adult) – Pharmacy Tool
Antimicrobial Traffic Lights (Paediatric) – Pharmacy Tool
AMS Traffic Light Procedure – Adults
AMS Traffic Light Procedure – Paeds
Please feel free to reach out to the antimicrobial stewardship team with any questions:
Adults
Monday to Friday 8am-4:30pm
Ph: 9594 3914
Pager: 3005 & 3002
Email: ams@monashhealth.org
Paediatrics
Mon, Wed, alt Thursdays 8am-4:30pm
Ph: 0400 220 632
Pager: 3013
Email: ams@monashhealth.org
Approved by Professor Allen Cheng, Director, Infectious Diseases