Antimicrobial stewardship: start smart then focus

This toolkit provides an outline of evidence-based antimicrobial stewardship in inpatient care settings.

Applies to England


Start smart then focus: resource materials – audit tools, review stickers and drug charts

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Following this toolkit will help organisations in England to demonstrate compliance with the Health and Social Care Act 2008: Code of Practice on the prevention and control of infections and related guidance.

The toolkit also supports recommendations made in the National Institute for Health and Care Excellence (NICE) Antimicrobial stewardship: systems and processes for effective antimicrobial medicine use guidelines (NG15), published August 2015.

It is designed to aid prescribers of antimicrobials in inpatient care settings abide by principles of good antimicrobial stewardship and assist antimicrobial stewardship teams in their activities.

A document with resource materials is provided alongside the toolkit. It includes examples provided by hospitals of:

  • audit tools
  • review stickers
  • drug charts
Published 17 November 2011
Last updated 12 September 2023 + show all updates
  1. Added resource materials.

  2. Updated contributors in Appendix 2.

  3. Updated guidance.

  4. PHE updated 'Start Smart Then Focus in 2015' in light of user feedback and newly published evidence.

  5. First published.