• Jonathan Cooke, Kelly Alexander, Esmita Charani, Kieran Hand, Tim Hills, Philip Howard, Conor Jamieson, Wendy Lawson, John Richardson, and Paul Wade.
• University Hospital of South Manchester NHS Foundation Trust and Manchester Academic Health Science Centre, Wythenshawe Hospital, Manchester, UK. jonathan.cooke@manchester.ac.uk
• J. Antimicrob. Chemother. 2010 Dec 1; 65 (12): 2669-73.

ObjectivesTo describe the methodology in developing an antimicrobial self-assessment toolkit (ASAT).MethodsThe ASAT was developed through a National Pharmacy Reference Group using an evidence-based approach of published information and national reports to identify criteria for inclusion. These were subdivided into domains that addressed: 1) Antimicrobial management within the Trust-structures and lines of responsibility and accountability-high-level notification to the Board. 2) Operational delivery of an antimicrobial strategy-operational standards of good antimicrobial stewardship. 3) Risk assessment for antimicrobial chemotherapy. 4) Clinical governance assurance. 5) Education and training-training needs and delivery of education and training for all who issue, prescribe and administer antimicrobials. 6) Antimicrobial pharmacist-systems in place for ensuring their optimum use. 7) Patients, Carers and the Public-information needs of patients, carers and the public.ResultsA web-based toolkit was developed using information from national reports and guidance on antimicrobial stewardship. The toolkit offers a checklist for hospitals to self-assess their organizations' levels of antimicrobial stewardship.ConclusionsThe ASAT offers a web-enabled, version-controlled instrument for the assessment of antimicrobial stewardship in acute hospitals. It may offer a sensitive instrument to assess longitudinal progress on antimicrobial stewardship in an individual institution or act as a benchmark with similar organizations. Further work is ongoing to evaluate and further refine the ASAT.

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