Key antibiotic stewardship issues

- Likely sub-optimal prescribing of antibiotics in primary care “lots of different antibiotics from the GP”
- Lack of patient knowledge about antibiotics and resistance and involvement in decision-making about their care “I should have said something…..consultants know best”
- Lack of staff knowledge and concern about antibiotic resistance “it wasn’t anything to be too concerned about”
- Poor adherence with antibiotic advice from the microbiologist and local antibiotic treatment guidelines “blockbuster antibiotics he normally uses for such cases”
- Length of antibiotic therapy “he normally says 14 to 28 days”
- A suggestion of inappropriate antibiotic use for prophylaxis (rather than therapy) “frequently he likes to use them [blockbuster antibiotics ] to prevent such infections” although “not on our policy”
- No evidence in the video of doctors and pharmacists (or an antimicrobial stewardship team) working together to optimise prescribing
- hand-washing (the patient’s wife recognised this to be sub-optimal)
- patient-to-patient contact encouraged by staff
- catheter insertion technique.
Antimicrobial Stewardship: Managing Antibiotic Resistance

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