World AMR Awareness Week (WAAW)- Antimicrobials In Clinical Practice
November 21, 2023
WAAW aims to raise awareness of antimicrobial resistance (AMR) – one of the leading risks to human health.
Today’s theme is ANTIMICROBIALS IN CLINICAL PRACTICE
Antimicrobials are fundamental to medical practice – but they are not a panacea to be used blindly. Our patients need the RIGHT agent, at the RIGHT dose, for the RIGHT duration by the RIGHT route.
Key national messages this WAAW:
- Refer to our Trust guidelines when selecting an antimicrobial.
- Clearly document a course length or a review date.
- Review regularly and consider switching IV to oral in line with new national guidelines
- A recent audit at UHB showed IV agents take more than sixteen times longer to administer than oral (22 minutes vs 80 seconds).
Would you like to know more?
Consider watching this Health Education England video on antibiotic prescribing in secondary care and reviewing the national Start smart – then focus guidelines (summarised below).
| START SMART | THEN FOCUS |
| · Do not start antibiotics in the absence of clinical evidence of bacterial infection
· Take cultures before antibiotic administration (do not delay antibiotics) · Check allergy history · Review previous microbiology · Adhere to SWB policies and guidelines · Document exact indication and duration of therapy in Unity · Give first dose within 1 hour for severe/life-threatening infections · Consult the duty microbiologist when appropriate. |
· At 48-72 hours review clinical diagnosis and continuing need for antimicrobials, and document clear plan of action in Unity. Please check culture and sensitivity results before starting antibiotics.
· STOP antibiotics if no evidence of infection · SWITCH from IV to oral therapy · CHANGE antibiotics: de-escalate/substitute/add agents as per culture results · CONTINUE and review again after a further 24 hours · CONSIDER potential for Outpatient Parenteral Antimicrobial Therapy |