1. Antimicrobial Update Frances Kerr Antimicrobial Pharmacist NHS Lanarkshire First Port > Public websites > MEDED > Drugs & Prescribing

6. Definition of antimicrobial stewardship “Prudent prescribing is not to prescribe as few antibiotics as possible but to identify that small group of patients who really need antibiotic treatment and then explain, reassure and educate the large group of patients who don’t. British Journal of General Practice 2009, 50:567

7. Path of least resistance VT Dr Gail Haddock, GP NHS Highland http://youtu.be/m5N3dcPmxW0

9. NHSL Total Antibiotic Use Acute Hospitals

10. A reduction in the unnecessary use of antibiotics will yield the following benefits: Reduction in the development of antimicrobial resistance at population and individual level, Reduction in CDI, Reduction in avoidable harm through fewer adverse effects, Reduction the medicalisation of self limiting conditions and the associated GP workload, Reduction of NHS prescribing costs.

11. New Quality indicator, June 2013-14 Antibiotic use, expressed in items/1000/day in at least 50% of practices in each NHS board will be at or below the 25th percentile of Scottish practices or will have made an acceptable move toward that level.

14. Audit of management of commonly encountered infection in primary care Number of consultations by infection

18. Booklet shared with parents in UK general practice Francis et al BMJ 2010

19. Public Awareness Campaigns

20. Delayed Scripts Delay for 48 hours prescription “Leave behind reception if no better in 2 days” Evidence to say – do work

21. Role of Individual Prescribers Awareness of local antimicrobial prescribing policy Minimise use of non-policy antibiotics and inappropriate dosage or duration Risk assess is it necessary to prescribe for self limiting diagnosis against individual patient circumstance Especially vigilant on antibiotic use in high risk “HAI vulnerable” groups e.g. Elderly, Nursing Homes

22. Questions?