Human medical practice

In the video above, Neil Powell, a consultant antimicrobial pharmacist at the Royal Cornwall Hospitals NHS Trust, shares his experiences in antimicrobial prescribing, from a human medical perspective. While you’re watching the video, think about how these challenges could relate to the challenges in veterinary practice that you’ve seen in the previous steps.

Challenges to achieving antimicrobial stewardship in a hospital setting:

• Empirical prescribing of broad spectrum antimicrobials prior to a diagnosis.
• Targeting antibiotic therapy to the infected tissue.
• Switching people from IV antibiotics to oral antibiotics once they’re improving.
• Giving the shortest possible antibiotic course once a diagnosis has been made.
• Stopping antibiotic treatment once an infection has been ruled out.

Challenges to achieving antimicrobial stewardship in a community setting (for example, a GP surgery):

• Very short appointment slots to see patients – not enough time to discuss alternatives to antibiotics.
• Very little patient follow-up and therefore no capacity to change antibiotic treatment halfway through.
• Longer courses of antibiotics have to be given because they cannot follow-up to see how the patient has responded to antibiotics.
• Lack of diagnostic tools, so limited initial knowledge of what you are treating.

Challenges in diagnostics:

Diagnostics is an emerging field with lots of new technology being invented. However, it is very difficult to then get these into hospitals and incorporate them with patient pathways as there is a high cost associated with the use of specialised diagnostics tools.

So why is this relevant?

Use the comments section below to discuss how this relates to veterinary practice. What are the similarities and differences between the challenges described here and what you see where you work?