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Primary Care Antimicrobial Update. Steve McCormick Lead Antimicrobial Pharmacist NHS Lanarkshire. Antimicrobial use is National priority. Scottish Antimicrobial Prescribing Group Local Antimicrobial Management Team Healthcare Environment Inspectorate. Stewardship: Prudent Prescribing.
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Primary Care Antimicrobial Update Steve McCormick Lead Antimicrobial Pharmacist NHS Lanarkshire
Antimicrobial use is National priority Scottish Antimicrobial Prescribing Group Local Antimicrobial Management Team Healthcare Environment Inspectorate
Stewardship: Prudent Prescribing Is an antibiotic required? Only use when clearly indicated Document decision making Tx rationale clear Select appropriateagent from local antimicrobial policy Minimise risk to patient Prescribe optimal dosage for shortest duration Ask specialist/micro for advice if unsure
Role of the AMT – Primary care Link in with Primary Care Prescribing Advisers who monitor prescribing using PRISMS Engage individual prescribers by feeding back meaningful data to promote reflection & discussion in order to influence future prescribing and promote compliance with policy Improve quality and reduce quantity of antimicrobial prescribing
SAPG Report on Antimicrobial Use and Resistance in Humans in 2010 Available from: http://www.isdscotland.org/Health-Topics/Prescribing-and-Medicines/Publications/2012-01-31/2012-01-31-SAPG-Report.pdf?81026858092
NHS Scotland: use of antibiotics associated with a higher risk of Clostridium difficile infection in primary care, items/1000/day, 2008 – 2011
NHS Scotland: use of recommended antibiotics in primary care, items/1000/day, 2008 – 2011
NHS Scotland: % seasonal variation of fluoroquinolones by NHS Board, (DDDs) 2008-09 – 2010-11 CEL 11 (2009) Seasonal Variation in use of quinolones. No more than 5% higher in winter than preceding summer by 2011.
NHS Scotland: total use of antibacterials in primary care 1995-2011 Total Use 2011 4.1% higher than 2010 (items/1000/day) = 162,000 more items 5.8% increase in DDD/1000/day (higher doses)
NHS Scotland: use of antibiotics in primary care by NHS Board, Items/1000/day, 2006-07 – 2010-11
NHS Scotland: Distribution of antibiotic use in GP practices (items/1000 patients/day) April 2010 - March 2011. Primary Care Antibiotic Indicator: Reduce volume of antibiotic scripts by 20%
SAPG audit of management of commonly encountered infection in primary care Number of consultations by infection
Stemming the tide of antibiotic resistance (STAR). A blended learning programme addressing appropriate antibiotic prescribing in general practice. Dr Sharon Simpson Associate Director, South East Wales Trials Unit, Cardiff University. BMJ 2012 http://www.stemmingthetide.org/
Booklet to use during the consultation & share with patients Francis et al BMJ 2010