Toggle Main Menu Toggle Search

Open Access padlockePrints

Importance of antimicrobial stewardship to the English National Health Service

Lookup NU author(s): Dr Christopher Duncan

Downloads


Licence

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Abstract

Antimicrobials are an extremely valuable resource across the spectrum of modern medicine. Their development has been associated with dramatic reductions in communicable disease mortality and has facilitated technological advances in cancer therapy, transplantation, and surgery. However, this resource is threatened by the dwindling supply of new antimicrobials and the global increase in antimicrobial resistance. There is an urgent need for antimicrobial stewardship (AMS) to protect our remaining antimicrobials for future generations. AMS emphasizes sensible, appropriate antimicrobial management for the benefit of the individual and society as a whole. Within the English National Health Service (NHS), a series of recent policy initiatives have focused on all aspects of AMS, including best practice guidelines for antimicrobial prescribing, enhanced surveillance mechanisms for monitoring antimicrobial use across primary and secondary care, and new prescribing competencies for doctors in training. Here we provide a concise summary to clarify the current position and importance of AMS within the NHS and review the evidence base for AMS recommendations. The evidence supports the impact of AMS strategies on modifying prescribing practice in hospitals, with beneficial effects on both antimicrobial resistance and the incidence of Clostridium difficile, and no evidence of increased sepsis-related mortality. There is also a promising role for novel diagnostic technologies in AMS, both in enhancing microbiological diagnosis and improving the specificity of sepsis diagnosis. More work is needed to establish an evidence base for interventions to improve public and patient education regarding the role of antibiotics in common clinical syndromes, such as respiratory tract infection. Future priorities include establishing novel approaches to antimicrobial management (eg, duration of therapy, combination regimens) to protect against resistance and working with the pharmaceutical industry to promote the development of new antimicrobials. © 2014 Dixon and Duncan.


Publication metadata

Author(s): Dixon J, Duncan CJA

Publication type: Review

Publication status: Published

Journal: Infection and Drug Resistance

Year: 2014

Volume: 7

Pages: 145-152

Online publication date: 30/05/2014

Acceptance date: 14/02/2014

ISSN (electronic): 1178-6973

Publisher: Dove Medical Press Ltd.

URL: https://doi.org/10.2147/IDR.S39185

DOI: 10.2147/IDR.S39185


Actions

Find at Newcastle University icon    Link to this publication


Share