Texas Health and Safety Code § 81.015 was codified in statute on September 1, 2019, and required DSHS to form an Antimicrobial Stewardship Regional Advisory Committee (ASRAC) in each of Texas’ eight Public Health Region (PHR). Texas’ Antimicrobial Stewardship Program successfully developed and coordinated these statewide ASRAC meetings, with valuable support from ASRAC partners.

The Texas Department of State Health Services’ (DSHS) Antimicrobial Stewardship Program is a collaborative, statewide initiative designed to empower healthcare providers and the public with useful education and tools to reduce antimicrobial misprescribing and resistance in Texas. Antimicrobials are substances that kill or stop the growth of microbes, including bacteria, fungi, or viruses.

Each ASRAC consisted of five voting members composed from the following categories:

• Physicians 
• Directors of nursing or other equivalent long-term care facility consultants
• Public health officials knowledgeable about antimicrobial stewardship
• Other interested parties

Goal of the ASRACs: To improve patient outcomes by promoting proper antimicrobial use and reducing the spread of antimicrobial resistance.

ASRAC Objectives:

1. Identify antimicrobial stewardship implementation barriers in long-term care facilities, as well as solutions and opportunities for improvement. 
2. Facilitate partnerships among antimicrobial stewardship stakeholders and public health to increase antimicrobial stewardship practices and policies in long-term care.
    

Each ASRAC met at least once. Meetings were open to the public and meeting notices and agendas were posted on the ASRAC webpage. The first meetings introduced members, discussed ethical considerations of advisory committees, and shared the DSHS Healthcare Safety Unit’s projects. Subsequent meetings addressed the concerns of each committee, including regional antibiogram creation, and educational resources for staff, families, residents, and physicians. Annual Texas Antibiograms were also shared with ASRAC members.

PHRs 7 and 11 addressed these concerns by establishing subcommittees:

1. PHR 7:
   • Urinary Tract Infection (UTI) and Urine Culture
   • Respiratory and Skin Infection
   • Materials Review
2. PHR 11:
   • Survey Development

Per Texas Government Code Sec. 2110.008 “Duration of Advisory Committees” statute, Texas advisory committees are automatically abolished on the fourth anniversary of their creation. As a result, the Texas ASRAC meetings are now officially ended.

DSHS continues supporting antimicrobial stewardship efforts in Texas, including building upon lessons learned from ASRAC meetings. For information on antimicrobial stewardship activities and resources, visit DSHS’ AS Resources and Training page. Stay informed about trainings, webinars, and other antimicrobial stewardship initiatives through the AS mailing list.

Questions: antibioticstewardship@dshs.texas.gov

Previous ASRAC webcasts can be searched and accessed here: Texas HHS Live and Archived Meetings.

Texas Government Code: 

• Sec 2110: GOVERNMENT CODE CHAPTER 2110. STATE AGENCY ADVISORY COMMITTEES (texas.gov) 
• Sec 121.007: HEALTH AND SAFETY CODE CHAPTER 121. LOCAL PUBLIC HEALTH REORGANIZATION ACT (texas.gov) 

Health and Safety Code:

• Sec. 81.015: HEALTH AND SAFETY CODE CHAPTER 81. COMMUNICABLE DISEASES; PUBLIC HEALTH DISASTERS; PUBLIC HEALTH EMERGENCIES (texas.gov)