Antibiotic campaign resources 2017/18

This year’s antibiotic campaign started on Monday 2 October.

The campaign pack includes links to posters,  how to issue the how to treat your infection patient leaflet from your clinical system etc:

Antimicrobial campaign pack 2017 – 18_V1 22-9-2017 (version 1 22.09.2017).

 

This year, national posters and leaflets are being supplied directly from Public Health England.

Public Health England has updated it’s resources toolkit for healthcare professionals this year ready for European Antibiotic Awareness Day. The Antibiotic Guardian materials have also been updated. You can get the new logo, for example for your e-mail signature, from this toolkit. You can choose one for your organisation or as an individual.

 

Leaflets and forms

A range of leaflets for patients is available from the Royal College of General Practitioners TARGET Antibiotics Toolkit page.

One can be used during consultations with women who are experiencing non-complicated urinary tract infections, when the clinician feels that the patient does not require an antibiotic prescription:

TARGET urinary tract infection information leaflet Nov 2016

The leaflet is available in different languages from the TARGET website.

 

For Care Home Staff

Form to complete and fax to GP if an older resident has a suspected urinary tract infection:

Management of UTIs in nursing homes form dec16 FINAL

 

EAAD factsheet and checklist for hospital prescribers

Factsheet on antibiotic resistance. Checklist before prescribing an antibiotic

 

For Nurses

RCN – Antimicrobial Resistance

 

For Dentists

This toolkit provides a set of resources to help promote the most appropriate use of antibiotics in dental care.

 

For Pharmacists and Pharmacy Technicians

Royal Pharmaceutical Society resources, including the pharmacy contribution to antimicrobial stewardship.

 

For Schools and other childcare facilities

A practical guide for staff on managing cases of infectious diseases in schools and other childcare settings.

 

National videos

Keep antibiotics working

When it comes to antibiotics take your doctor’s advice

 

Handwashing

A survey by the Royal Pharmaceutical Society has found that 84% of British adults don’t wash their hands for long enough. A guide on how to wash hands is available from their website.

 

Some headlines from NICE

Do not issue repeat prescriptions for antimicrobials unless patient has a particular clinical need. Avoid issuing repeat prescriptions for longer than 6 months without review. Monitor patients to reduce risk of side effects and check if antimicrobial is still needed (NG15).

Self-care includes resting, drinking plenty of fluids and taking over-the-counter preparations for symptom relief if necessary. Promote community pharmacies as easily accessible places to obtain advice on managing self-limiting infections. Give people information on the importance of hand-washing (NG63).

 

Some evidence

Effect of antibiotic stewardship on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infection: a systematic review and meta-analysis

A review found that antimicrobial stewardship programmes alone may reduce overall antibiotic resistance by 19% (incidence ratio [IR] 0.81, 95% confidence interval [CI] 0.67 to 0.97). Combining stewardship programmes with procedures for controlling infection appears to reduce antibiotic resistance by 31% (IR 0.69, 95% CI 0.54 to 0.88). Combining stewardship programmes with hand-hygiene appears to be the most effective combination, reducing antibiotic resistance by 66% (IR 0.34, 95% CI 0.21 to 0.54). These programmes also reduced the incidence of multi-drug resistant gram-negative bacteria and extended spectrum beta-lactamase producing gram-negative bacteria such as E. coli.

 

Behaviour change and antibiotic prescribing in healthcare settings – literature review and behavioural analysis

Literature review of key behaviours which support antibiotic stewardship. Interventions included online pledges for parents; making delayed prescriptions the default for respiratory infections; changing design of hospital prescription charts; and enhanced feedback on prescribing behaviours.

 

Stemming the Tide of Antibiotic Resistance (STAR)

An educational programme used in general practice – included feedback on prescribing data and case scenarios.

 

Antibiotic prescription strategies and adverse outcome for uncomplicated lower respiratory tract infections: prospective cough complication cohort (3C) study

A UK general practice cohort study looked at lower respiratory tract infection in 28,883 patients aged 16 and over.  104 (0.4%) were referred to hospital for radiographic investigation or admission, or both on the day of the index consultation, or were admitted with cancer. Of the remaining 28 779, subsequent hospital admission or death occurred in 26/7332 (0.3%) after no antibiotic prescription: 156/17 628 (0.9%) after prescription for immediate antibiotics; and 14/3819 (0.4%) after a prescription for delayed antibiotics. Analysis found no reduction in hospital admission and death after immediate antibiotics and a non-significant reduction with delayed antibiotics. Re-consultation for new, worsening, or non-resolving symptoms was common (1443/7332 (19.7%), 4455/17 628 (25.3%), and 538/3819 (14.1%), respectively) and was significantly reduced by delayed antibiotics but not by immediate antibiotics. The authors concluded that if clinicians are considering antibiotics, a delayed prescription may be preferable to an immediate prescription.

An accompanying editorial notes:

“The most important findings were that serious adverse events such as death or hospital admission are rare in people with acute cough and that an immediate antibiotic prescription is not associated with a significantly reduced risk.

This study adds to others showing that not offering an immediate prescription for antibiotics to people with common uncomplicated acute respiratory infections is a low risk strategy”

 

Delayed antibiotic prescribing strategies for respiratory tract infections in primary care: pragmatic, factorial, randomised controlled trial

Strategies of no prescription or delayed antibiotic prescription resulted in fewer than 40% of patients using antibiotics, and are associated with less strong beliefs in antibiotics, and similar symptomatic outcomes to immediate prescription. If clear advice is given to patients, there is probably little to choose between the different strategies of delayed prescription.

 

Antibiotic prescription strategies for acute sore throat: a prospective observational cohort study

Cohort of 12,829 adults presenting with sore throat (≤2 weeks duration) in primary care – suppurative complications are not common in primary care and most are not serious. The risks of suppurative complications or re-consultation in adults are reduced by antibiotics, but not as much as the trial evidence suggests. In most cases, no antibiotic is needed, but a delayed prescription strategy is likely to provide similar benefits to an immediate antibiotic prescription.

 

Education targeted at both parents and GPs reduces antibiotic prescribing for children

Systematic review of 12 educational interventions found that interventions were associated with lower rates of antibiotic prescribing vs usual care (odds ratio 0.63, confidence interval 0.50 to 0.81). UK study targeted both clinicians and parents through use of an interactive booklet during the consultation. In the index consultation, antibiotics were prescribed 19.5% in the intervention group and 40.8% in the control group.

 

Some national learning resources

Health Education England e-learning on antimicrobial resistance.

Target training resources. These include antibiotic resistance, urinary tract infections, sexual health, skin.

Online courses at Future Learn. These include ones about antimicrobial resistance.

Education and training section in Antimicrobial Resistance Resource Handbook. These include infection control and antimicrobial stewardship.

NECS e-learning: antibiotic prescribing and antimicrobial stewardship in primary care.

For the pharmacy workforce (CPPE). These include antibacterial resistance, antibacterials.

e-Bug has learning resources for children and young people.

TED-Ed – What causes antibiotic resistance?

 

Other resources

PHE Antimicrobial Resistance AMR Toolkit for Public Engagement April 2017

NICE

Clinical Knowledge Summaries

UK 5-year antimicrobial resistance strategy 2013-2018

What vets are doing to tackle antibiotic resistance

Antimicrobial Resistance Resource Handbook

Green Book

International Pharmaceutical Federation: Control of Antimicrobial Resistance (AMR)

 

Some data on antibiotic usage

Fingertips – AMR local indicators

PrescQIPP – see section on antimicrobial stewardship in the Data Hub

Quality premium antibiotic dashboard

ESPAUR report – English surveillance

 

National and international campaigns

European Antibiotic Awareness Day: 18 November

WHO World Antibiotic Awareness Week: 13 – 19 November