Antimicrobial Stewardship

Edited by Matthew Laundy, Mark Gilchrist, and Laura Whitney

An essential guide to the principles of antimicrobial stewardship written by authors working in the field
Provides practical advice illustrated by case studies
Covers issues specific to the UK and rest of world

Antimicrobial Stewardship

Edited by Matthew Laundy, Mark Gilchrist, and Laura Whitney

Description

Antimicrobial resistance (AMR) challenges the treatment of clinical infections. Despite the decline in infectious diseases mortality rates, infections are more difficult to eliminate or contain in the host, resulting in poorer outcomes to treatment, longer hospital inpatient stays, and increased mortality.

Written by international experts in the field and supported by the review of the available evidence, including example case studies, Antimicrobial Stewardship provides a practical how-to guide on this growing area. Divided into three sections, the first sets the scene, looking at the key problems of antimicrobial resistance. Section two examines and identifies the key components of an antimicrobial stewardship program. Finally, the book explores specialist areas of antimicrobial stewardship ranging from antimicrobial pharmacokinetics and dynamics, to near patient testing, and infection biomarkers.

Antimicrobial Stewardship will be a valuable and practical resource for infection trainees, as well as specialists from the medical, pharmacy, and nursing professions.

Antimicrobial Stewardship

Edited by Matthew Laundy, Mark Gilchrist, and Laura Whitney

Preface
Abbreviations
Section 1: Setting the scene and starting up:
1. The international and national challenges faced in ensuring the prudent use of antimicrobials, Susan Hopkins
2. What are the principles and goals of antimicrobial stewardship, Fiona Robb and Andrew Seaton
3. Managing behaviours: Social, cultural and psychological aspects of antibiotic prescribing and use, Esmita Charani and Gabriel Birgand
4. Implementing an Antimicrobial Stewardship Programme, Patrick Doyle
Section 2: Components of an Antimicrobial Stewardship Program
5. Managing antimicrobials on the shop floor, Antonia Scobie, Mark Gilchrist, Laura Whitney and Matthew Laundy
6. Measuring antibiotic consumption and outcomes, Hayley Wickens
7. Measuring and feeding back stewardship, Jacqueline Sneddon and Billy Malcolm
8. Information technology in antimicrobial stewardship, Matthew Laundy
Section 3: Special Areas in Antimicrobial Stewardship
9. Pharmacokinetic and Pharmacodynamic Principles of Antimicrobials, Jason Roberts and Menino Osbert Cotta
10. The Role of the Microbiology Laboratory in Antimicrobial Stewardship, Peter Riley
11. Antimicrobial Stewardship in the Immuno-Compromised Patient, Haifa Lyster
12. Antimicrobial Stewardship in the Intensive Care Setting, Jonathan Ball
13. Surgical Prophylaxis, Tamsin Oswald, Simon Jameson, Mike Reed
14. Antimicrobial Stewardship in Paediatrics, Sanjay Patel and Julia Bielicki
15. Stewardship in the primary care and long term care setting, Naomi Flemming
16. Antifungal Stewardship, Laura Whitney and Tihana Bicanic
17. Near Patient Testing and infection biomarkers, Matthew Dryden
18. Antimicrobial Stewardship in a Resource Poor Setting, Marc Mendelsohn

Antimicrobial Stewardship

Edited by Matthew Laundy, Mark Gilchrist, and Laura Whitney

Author Information

Matthew Laundy, Consultant Microbiologist, St George's University Hospitals, NHS Foundation Trust,Mark Gilchrist, Consultant Pharmacist, Imperial College Healthcare NHS Trust,Laura Whitney, Consultant Pharmacist, St George's University Hospitals NHS Foundation Trust

Matthew Laundy is a consultant microbiologist at St George's University Hospitals NHS Foundation Trust. He has a special interest in antimicrobial stewardship, OPAT, paediatric infections and medical informatics. He is a Fellow of the Royal College of Pathologists and a member of the Royal College of Paediatrics and Child Health.

Mark Gilchrist is a Consultant Pharmacist in Infectious Diseases at Imperial College Healthcare NHS Trust, and an Honorary Lecturer at Imperial College, London. Mark has a specialist interest in Outpatient Parenteral Antimicrobial Therapy (OPAT) and global antimicrobial stewardship initiatives. Mark is a past chair of UK Clinical Pharmacy Infection Network and is a spokesman for the Royal Pharmaceutical Society on Antimicrobials. In 2013 Mark was awarded Fellow of the Royal Pharmaceutical Society Faculty.

Laura Whitney is a Consultant Antimicrobial Pharmacist at St George's University Hospitals NHS Trust and an Honorary Senior Lecturer at Kingston University. Her specialist interests include; antimicrobial stewardship, management of invasive fungal infections, and the treatment and prevention of Clostridium difficile infection. Laura is a member of the Royal Pharmaceutical Society of Great Britain and is a current committee member of the UK Pharmacy Infection Network.

Contributors:

Jonathan Ball, Consultant and Honorary Senior Lecturer in General and Neuro Intensive Care, St Georges University Hospitals NHS Foundation Trust, London, UK

Julia Bielicki, Clinical Research Fellow, Paediatric Infectious Diseases Research Group, Institute for Infection and Immunity, St George's University of London, London, UK

Tihana Bicanic, Consultant in Infectious Diseases, St George's University Hospitals NHS Foundation Trust, London, UK

Gabriel Birgand, Research Associate, NIHR Health Protection Research Unit, Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, UK

Esmita Charani, Academic Research Pharmacist, NIHR Health Protection Research Unit, Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, UK

Menino Osbert Cotta, Associate Lecturer, Burns Trauma and Critical Care Research Centre, The University of Queensland; Senior Pharmacist, Royal Brisbane and Women's Hospital; and
Research Fellow, Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Australia

Patrick Doyle, Pharmacy CG and Risk Lead, Frimley Health NHS Foundation Trust, Wexham Park, UK

Matthew Dryden, Consultant Microbiologist and Infection Specialist, Hampshire Hospitals Foundation Trust; and Rare and Imported Pathogens Department, Public Health England, Southampton University School of Medicine, UK

Naomi Flemming BPharm, MRPharmS, PGDip, PhD
Kettering General Hospital, Kettering, UK
UKCPA PIN Committee

Mark Gilchrist MPharm MSc IPres FFRPS
Consultant Pharmacist Infectious Diseases, Imperial College Healthcare NHS Trust, London
Honorary Lecturer, Imperial College London, UK

Susan Hopkins, Consultant in Infectious Diseases and Microbiology, Royal Free London NHS Foundation Trust; Healthcare Epidemiologist, Public Health England; and Honorary Senior Lecturer, University College London, UK

Simon S. Jameson, Robin Ling Hip Fellow, Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter NHS Foundation Trust, UK

Matthew T. Laundy, Consultant in Medical Microbiology, Clinical Lead for Antimicrobial Stewardship and Trust Infection Control Doctor, St Georges University Hospitals NHS Foundation Trust, London, UK

Haifa Lyster, Consultant Pharmacist, Transplantation and VADs, Royal Brompton and Harefield NHS Foundation Trust, London, UK

William Malcolm, Pharmaceutical Adviser, NHS National Services Scotland, UK

Marc Mendelson, Professor of Infectious Diseases, Head of Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa

Tamsin Oswald, Northumbria Healthcare NHS Foundation Trust, UK

Sanjay Patel, Consultant in Paediatric Infectious Diseases and Immunology, Southampton Children's Hospital, UK

Mike Reed, Institute of Cellular Medicine, University of Newcastle; and Northumbria Healthcare NHS Foundation Trust, UK

Peter Riley, Consultant Medical Microbiologist, St Georges University Hospitals NHS Foundation Trust, London, UK

Jason A. Roberts, NHMRC Career Development Fellow, Burns Trauma and Critical Care Research Centre, The University of Queensland; and Pharmacist Consultant, Royal Brisbane and Women's Hospital, Australia

Fiona Robb, Antimicrobial Pharmacist, NHS Greater Glasgow and Clyde Health Board, South Glasgow University Hospital, UK

Antonia I. Scobie, Specialist Registrar in Microbiology and Infectious Diseases, St Georges University Hospitals NHS Foundation Trust, London, UK

R Andrew Seaton, Consultant in Infectious Diseases and General Medicine; and Antimicrobial Management Team Lead, NHS Greater Glasgow and Clyde Health Board,
South Glasgow University Hospital, UK

Jacqueline Sneddon, Project Lead for Scottish Antimicrobial Prescribing Group, Healthcare Improvement Scotland, UK

Hayley Wickens, Consultant Pharmacist, Anti-Infectives, University Hospital Southampton NHS Foundation Trust, UK

Laura Whitney, Consultant Pharmacist; Antimicrobials and Pharmacy Lead for Antimicrobial Stewardship, St George's University Hospitals NHS Foundation Trust; and Honorary Senior Lecturer, Kingston University, London, UK