How Can We Take Key Actions to Reduce Antimicrobial Resistance (AMR)?

In the UK in 2019, between 7,576 and 35,162 people died because of bacterial AMR. Globally, more people died due to reasons related to AMR than HIV/AIDS or malaria.

The added burden of AMR to the NHS includes extra primary care appointments, more hospital admissions, higher bed occupancy and longer lengths-of-stay. [OECD].

🚨🚨Action 1🚨🚨: Optimise Antimicrobial Prescribing

• 🕒 Shortest Effective Course: Support prescribers to follow NICE guidelines by prescribing the shortest effective antibiotic course. Advise patients to take antibiotics as directed, never to save for later or share, and to return unused antibiotics for safe disposal.

• 🦷 Dental Prescribing Practices: Alert dental practitioners to follow the 2020 Good Practice Guidelines and utilize the Dental Antimicrobial Stewardship Toolkit.

• 🔄 IV to Oral Switch: Implement timely switching from intravenous to oral antibiotics to reduce hospital stays, save nursing time, and decrease the NHS carbon footprint.

• 🏥 Reduce "Watch" and "Reserve" Antibiotics in Hospitals: Aim to lower inpatient exposure to critical antibiotics as per the UK AMR National Action Plan and NHS Standard Contract 2023/24.

🚨🚨Action 2🚨🚨: Implement Infection Prevention and Control (IPC) Measures

• 🚫 Strong IPC Practices: Employ robust IPC measures as detailed in the National Infection Prevention and Control Manual (NIPCM) to control the spread of AMR, improve hygiene, and reduce unnecessary antibiotic use.

• 🧼 Promote Hygiene: Focus on hand hygiene and hospital cleanliness to prevent infections and reduce antibiotic dependency.

🚨🚨Action 3🚨🚨: Conduct Audits and Action Plans

• 🧪 Blood Culture Audits: Follow the improving blood culture pathway report, use the audit tool from the Office of the Chief Scientific Officer’s FutureNHS Workspace to review and improve diagnostics and treatments for patients with sepsis.

📩 Contact for Assistance: For any questions, contact england.prevention-amr@nhs.net, your ICB AMR lead, or NHS England regional Antimicrobial Stewardship Lead at england.amrprescribingworkstream@nhs.net.

Note: These actions aim to optimise antibiotic usage, enhance patient care, and contribute to the global effort against AMR.

References:

• https://www.oecd.org/els/embracing-a-one-health-framework-to-fight-antimicrobial-resistance-ce44c755-en.htm

• https://model.nhs.uk/

• https://www.england.nhs.uk/publication/national-infection-prevention-and-control/

• https://www.gov.uk/government/collections/european-antibiotic-awareness-day-resources

• https://www.rpharms.com/resources/pharmacy-guides/ams-amr

• https://www.e-lfh.org.uk/programmes/antimicrobial-resistance-and-infections/

• https://antibioticguardian.com/