DILIP NATHWANI

DILIP NATHWANI

I am a doctor with 25+ years of interest and experience in improving the use of antibiotics. Through better education, to promote better patient management and treatment.

Location I am a Infectious disease physician and Honorary Professor of Infection based at Ninewells Hospital and Medical School in Dundee, Scotland, UK.

Activity

  • Dear all,
    My apologies for not responding during week 1- this was due to some access difficulties. Hope you enjoyed the scene setting. Now you get into the details of antibiotic preservation /stewardship. The recent landmark UN resolution has given all countries 2 years to come up with a framework and action on key aspects of fighting AMR. Education and...

  • I have scanned many of your responses and occasionally commented; you are along the right direction and are identifying many of the things that were suboptimal here; we hope to come back to many of them and use them as a stimulus to help us think how we could do better and the science that supports this
    Keep up the great start- your learning journey has just...

  • What a high quality response; you have most of the key points we wishes for you to think about

  • Our problem is we have been less successful in the hospital

  • Actually, in the UK, there are fantastic protocols for prescribing and our increasing evidence is that GP's are doing very well in following this as antibiotic prescribing rates are coming down !

  • The challenging bit is how do we get professionals to adhere to guidance etc
    This will be discussed in more detail in week 5; critical to better implementation

  • Yep, all relevant.

  • Dear all
    Thanks for joining our course; in keeping with previous ones we continue to attract a diverse range of people, disciplines and countries. We hope you find our course helpful; your feedback in very important to us as we strive to improve and be relevant to your needs. good luck and keep up the hard work !!

  • just completed indian survey of stewardship education needs; interesting findings

  • welcome; much being done in veterinary amr now under the one world agenda; ours is entirely human focused but hope you find it helpful

  • Thank you for joining; we sincerely hope you enjoy this course
    keen to hear of your feedback

  • You certainly have a major problem but lots of good work in stewardship coming from south africa; refer you to the work of SAASP ; WELCOME

  • Welcome; first from lesotho; very commendable of you and hope we can work closely together with all our partners

  • Hello Gloria
    Thanks; as i said our programme is hospital focused; we do plan in the future to include community practice but there is much generic learning here also which i hope you find helpful
    please enjoy the course

  • Thank you for joining Esra- hope you find it helpful; week 6 share experience from less resource rich countries which i hope you find relevant; we do plan to evolve our course so it reflect broad needs of our participants; keen to from you and all others through feedback

  • Hi kirsty
    thanks for your interest; you may find this perhaps hospital focused but much generic learning also; suggest also go to SAPG website for scotland stewardship ; welcome and enjoy !

  • Hello
    Thanks for joining; there is a stewardship component to the semmeweis foundation confrence in march 2017 in budapest- you should check it out
    enjoy the course

  • welcome; we have lots of collaborations with australia; you guys are doing great work in stewardship; hope you enjoy the course

  • welcome
    we are participating in the ICAN africa meeting in joburg in september; looking particularly at role of nurses in stewardship in Africa

  • Welcome to our course; delighted to see this in germany- we will certainly look at this; enjoy the course and hope you find it helpful

  • see my comments above

  • How true Nyawira. I believe it is hightime the infection community stops agreeing what needs to be done within their own field, because we know, but engage with the clincians. I think 2 papers are a must read: refs :L Charani et al BMJ Quality Saf 2013; ):1-3 & JAC Rawson et al 2016; 71(2): 554-9; it talks wider and crosss specialty engagement

  • Thanks to all. I have seen more repsonses and they are alligned to what you will learn more about in the subsequent weeks. Thank you all for your discussions and enjoy the rest of the course.
    Look forward to reading more of your interactions with other participants and of course the educators.

    Welcome to week 2 .

  • Agree but more complex than what you outline. Weeks 2,3 and 5 will be valuable here

  • Agree, but not as easy to implement as you thhink; week 5 you will learn more

  • Thank you all for your comments. The scenation not only resonates with many of you but your are identifying the issues- exactly what we wanted and some of oyu are raising important additional questions that are relevant to the healtrcare setting, resource and geography you live or work in. We find these very instructive.

  • Good to see many of you discussing; looking forward to hearing from others

  • all very relevant concepts and need for the "one health approach"

  • Communication is fundamental; if you go to the Health Foundation uk website they have a paper and guidance on effective communication ; very relevant to stewardship and worth considering

  • I am pleased to see you are posting and responding ;the range of views is great and a basis for what we will embark upon later on in the course; keep it up

  • Not only infection control; if we did not prescribe antibiotics resistance would not happen or happen a lot less
    AMR needs a range of responses of which infection control is one key part

  • A theme about authority others have referred to; i have commented before and will be discussed again later

  • yes agree; many of these issues will be referred to as we go into more detail; please remember/re-refer to this scenario as we come back to it often through the MOOC

  • We accept not only the antibiotics in farming, but veterinary medicine, fisheries, waster- etc

    All part of the "one health " repsonse- we are addressing one small part of it

  • Spot on- got many of the key things

  • I note a great mixture of health care professionals and others ; hope you all get something out of this; please hang in there for the 6 week journey- it will be worth it!

    best wishes

  • Dear colleagues

    My most sincere welcome. from Baghdad, to Crete to Calgary to Kenya to Mexico to India etc etc and those at home in the UK its my pleasure to interact with you. I do hope you enjoy the course and the team and i look forward to learning with you.

  • I congratulate you on your work and ambition; i hope you engage with this course and encourage others to take part- you will learn of a lot of good practice is a range of countries and hopefully they will resonate with you
    well come and enjoy the course

  • Mandate v persuation/encouragement is a long standing debate' both have a place and something that will recur in our discussions

  • well made points and hard to argue against
    remember here its not only about nosocomial infection; its about all infections

  • So pleased you have all started- day 1 and already some very pertinent discussions
    thank you and enjoy the rest of the course; lots of good stuff yet to come

  • Clinician engagement and poor leadership are fundamental to effective stewardship programmes; a theme as we progress over the 6 weeks; hang in there and you will learn more and interact with some great learning
    thanks and welcome

  • I agree with your sentiments; the scenario tries to portray many challenges and poor practices