Antimicrobial Stewardship (AMS)

Program
Programs initiated in hospitals in an effort to improve on antibiotic use by both patients and clinicians
to be able to competently treat infections, protect patients from unnecessary antibiotic use, and
control antibiotic resistance

7TH DAY AUTOMATIC STOP POLICY

A policy that modulates the duration of antimicrobial therapy
through necessitating a regular review and assessment of prescriptions,
especially if therapy is required to be continued beyond 7 days

RATIONALE EXCEPTIONS
Infections are to be effectively Patients with:
treated with the least amount of time
possible

Unneeded extension of exposure to

antimicrobial agents unduly exposes
patients to adverse effects,
emergence of drug-resistant
organisms, and increased costs HIV/AIDS Tuberculosis
Cancer

Filling of 7th-day antimicrobial form is

SCOPE
Includes the use of ANY and ALL
antimicrobial agents administered either
orally or intravenously
Applicable only to patients admitted
within the hospital (in-patients setting)
NOT needed if:
Entirety of treatment duration is ≤7 days
Written recommendation for >7 days has
been made by AMS (Antimicrobial
Stewardship) clinician, IDS (Infectious
Disease) chairperson, or IPC (Infection
Prevention and Control) chairperson

Upon approval of the AMS officer, the documented resolution

Pharmacists must only dispense antimicrobials from
prescriptions that are good for 7 days worth of
treatment. After which, an automatic stop for
antimicrobial use shall be imposed.
Clinical pharmacist and/or Registered Nurse informs the
doctor on day 6 of antimicrobial treatment.
If the doctor decides to continue the treatment beyond 7
days, they must accomplish the 7th Day Antimicrobial Form
(SDAF) and must seek approval from the AMS clinician/officer
through phone consultation explaining the reason why the
treatment must be extended.
and form shall be given to the pharmacy. It is only then
should the pharmacist dispense the medicine/s based on the
therapy duration.
The nurse shall then give and administer the medication/s.
The AMS officer shall verify the information stated and
sign the form no later than the morning of the next
working day to document their approval.
The SDAF is NOT NEEDED to be accomplished when:
1. Antimicrobial pharmacotherapy is meant for less than or
equal to 7 days.
2. Antimicrobial Pharmacotherapy beyond 7 days is
recommended by the AMS officer wherein such
recommendation must be written as evidence for the
pharmacy to dispense and the nurse to administer

ADVANTAGES

Avoid excessively Promotes reevaluation of need to alter

Decrease drug costs
prolonged therapy therapy or route of administration

GUIDELINES
Antimicrobial usage for 7 days shall be calculated as follows:
a. Once a day administration: first day dose plus 6 days.
b. Administered with more than 24 hours interval or divided doses: first-day
dose plus 7 more days.
c. Patients that were transferred to the hospital from another healthcare
institution that are currently taking antimicrobials, the original date for the first
dose must be used to calculate the duration of therapy.
d. Loading and missed doses must be a part of the antimicrobial treatment
duration of days is dependent on the culture sensitivity result and AMS team’s
decision.
e. Changes in administration routes or antimicrobial drugs through escalation or de-escalation, the
counting of days shall be carried on to apply. It must be noted that when altering or changing the
antimicrobial, counting of days is dependent on the culture sensitivity result and AMS team’s decision.

References
Department of Health (DOH). (2016). Antimicrobial Stewardship Program in Hospitals: Manual of Procedures.
Department of Health – Pharmaceutical Division.