Antimicrobial stewardship

Sepsis is treated with antibiotics. However, antibiotic resistance (a term called antimicrobial resistance or AMR) now poses a significant threat to the delivery of healthcare. It is therefore imperative to ensure that principles of good antimicrobial stewardship and appropriate use of antibiotics are built into all activities, communication, training and actions relating to the treatment of sepsis.

Antimicrobial resistance is a national and global threat to health (The Review on AMR) as no new antibiotics have been developed in the past 30 years and increasing bacterial resistance to those antibiotics in current use means infections are becoming harder to treat. There are currently 25,000 deaths a year in Europe caused by infections that have no effective antibiotic treatment. The UK 5 Year Antimicrobial Resistance Strategy 2013-18 has seven objectives, one of which is optimising antimicrobial prescribing practice. This is an NHS patient safety priority, with a national ambition to reduce both inappropriate antibiotic use, and health care associated gram negative blood stream infections by 50% by 2020/21.

The English surveillance programme for antimicrobial utilisation and resistance (ESPAUR) reports 75% of antibiotic prescribing originates in primary care, and national targets have been set to drive the reduction of inappropriate antibiotic prescribing in primary care using the MOKTT9 indicators.

Key documents, resources, websites, networks and partner organisations

The joint NHS Improvement and NHS England Patient Safety Alert addresses antimicrobial resistance through implementation of an antimicrobial stewardship programme.

NICE guidance includes the new Common Infections Guidance – these are published as rapid guidance within an ongoing programme and provide primary and secondary care with resources to promote appropriate antimicrobial use at a whole health economy level, and support NG15 and NG63:

PHE Managing common infections: guidance for primary care to support health economies develop antimicrobial prescribing guidelines for local use.

HEE e-learning resources for Antimicrobial Resistance.

RCGP host the PHE TARGET toolkit providing educational and audit resources to support antimicrobial stewardship activity in primary care.

PrescQIPP Antimicrobial Stewardship Hub is a collaboration between NHS England and NHS Improvement providing a one-stop resource for CCGs, linking to PHE, HEE, NICE and other AMR resources and providing primary care prescribing data at CCG and GP practice level in a free access, ready to use format.