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Antimicrobial stewardship

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  • Mycoplasma genitalium bacteria

    Antibiotic treatment of Mycoplasma genitalium infection Subscription

    An overview of the 2018 guideline for management of this sexually transmitted infection in men and women.

  • Hospital pharmacy store room

    How precarious antibiotic supplies are putting patients at risk Subscription

    The antibiotic supply chain is “at risk of collapsing”, which could lead to major problems treating serious infections and add to resistance levels.

  • Antibiotic testing, antimicrobial resistance (AMR), agar dish

    Pharmacy’s role in antimicrobial resistance and stewardship Subscription

    This article summarises the evidence supporting the role of pharmacists and pharmacy teams in antimicrobial stewardship and outlines the impact of their activities.

  • Illustration of MRSA cells

    The global race to combat antimicrobial resistance Subscription

    The Longitude Prize has relaunched after 300 years and this time teams around the world are racing to develop a rapid point-of-care diagnostic test that will help prevent the overuse of antibiotics and put them in the running to win £8m.

  • 2017 end of year review concept

    2017: Pharmacy's roller-coaster year Subscription

    It has been an unsettling 12 months for pharmacy and as 2017 draws to a close there are still a number of unresolved issues hanging over the New Year.

  • Research on antimicrobial resistance

    AMR and diagnostics: pointing the way to better infection control Subscription

    Antimicrobial resistance — the ability of previously sensitive microorganisms to resist the effects of an antimicrobial agent — is a growing problem. The World Health Organization has warned that we could be moving into a post-antibiotic era where even minor injuries could lead to life-threatening infections, consequently putting an end to complex surgery and returning us to an era where childbirth is high-risk.

  • Scanning electron micrograph of methicillin-resistant Staphylococcus aureus (MRSA) bacteria

    Antimicrobial therapies for Gram-positive infections Subscription

    Gram-positive bacteria are among the most common human pathogens associated with clinical infections, which range from mild skin infections to sepsis. In an era defined by antimicrobial resistance (AMR) and an increasing drive toward delivering patient care via ambulatory pathways, the paradigm for the management of infections is changing. Methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), the best known cases of ...

  • Micrograph of Acinetobacter baumannii bacteria

    Ceftazidime-avibactam: a novel cephalosporin/β-lactamase inhibitor Subscription

    Over the past decade, infections caused by multidrug-resistant Gram-negative organisms have increased. The limited availability in treatment options for these infections prompted both the UK to create a five-year antimicrobial resistance strategic plan to stimulate the development of new antibiotics, and the Infectious Diseases Society of America to call for ten new antimicrobial agents to be developed by 2020. Ceftazidime-avibactam is a combination of a third-generation ...

  • Micrograph of Clostridium difficile bacteria

    Clostridium difficile: diagnosis and treatment update Subscription

    There are around 12,000 cases of Clostridium difficile infection (CDI) each year in the UK and during 1999 to 2007, deaths from CDI peaked at around 4,000 per year. This article summarises diagnosis and management, as well as the current therapeutic options for CDI, including faecal microbiota transplant.

  • Molecular model of C-reactive protein

    Evaluating a point-of-care C-reactive protein test to support antibiotic prescribing decisions in a general practice Subscription

    C-reactive protein (CRP) is a marker of infection and inflammation. It is high in bacterial infections but very low or close to zero in viral infections. The National Institute for Health and Care Excellence (NICE), England and Wales’s health technology assessment body, has issued guidance on pneumonia in adults; it recommends point-of-care (POC) CRP analysers when clinical assessment is inconclusive. If the CRP level is less than 20mg/L, no antibiotics ...

  • Collage showing MRSA, research and antibiotics

    New approaches to overcoming antimicrobial resistance Subscription

    As antibiotic resistance continues to threaten the treatment of various infections, researchers are looking for new ways to supplement and in some cases replace failing antimicrobial drugs.

  • Illustration antibiotic destroying bacteria

    Principles of initiating antimicrobial therapy and empiric prescribing Subscription

    Healthcare professionals should be aware of the principles of antimicrobial treatment and the need to reduce inappropriate prescribing to retain the effectiveness of drugs currently available.

  • Pharmacy professionals have the opportunity to specialise in a variety of clinical areas

    Specialist roles in hospital pharmacy Subscription

    Pharmacy professionals have the opportunity to specialise in a variety of clinical areas. Eamonn McArdle explores the possibilities.

  • Gentamicin is an aminoglycoside antibiotic commonly used for the treatment of infections and surgical prophylaxis. In the image, surgeons in the middle of an operation

    Gentamicin: dose regimens and monitoring

    How to calculate the correct dose of gentamicin and monitor patients to prevent toxicity.

  • Healthcare-associated infection in England was 6.4% in 2011 and six common infections accounted for over 80% of infections in adults. In the image, a petri dish with a staphylococcus aureus culture

    Healthcare-associated infection: best practice in prevention and control Subscription

    Understand the standard principles and practices of infection control, with a brief overview of initiatives aimed at reducing rates of infection acquired in a healthcare setting.

  • Urinary tract infection (UTI) is one of the most common reasons for using antibiotics in both primary and secondary care. Escherichia coli (micrograph pictured) is still the most common causative organism

    Urinary tract infection: management in elderly patients Subscription

    Around 10% of older people, and almost a third of care home residents, develop a urinary tract infection each year.

  • Learning articles of the year: check your knowledge of subjects ranging from ebola to QT syndrome.

    Highlights of CPD and learning in 2014 Subscription

    Try our clinical quiz, taken from this year’s learning articles, and check your knowledge of subjects ranging from Ebola to QT syndrome.

  • New drugs are under development to reduce the use of antibiotics in animals and help slow the rise of antimicrobial resistance in humans

    Strategies to reduce the use of antibiotics in animals Subscription

    New drugs that could eventually replace or reduce the use of antibiotics in animals are in development to help slow the rise of antibiotic resistance.

  • Chlamydia (pictured) is one of a series of sexually transmitted infections (STIs) that have increased considerably in the last ten years

    Treating bacterial sexually transmitted infections Subscription

    With azithromycin made available over the counter for chlamydia treatment, this CPD article reviews how to identify and treat the most prevalent sexually transmitted infections.

  • Growing antimicrobial resistance is growing and results in 25,000 deaths in Europe each year. In the image, enterobacteriaceae (CRE) bacterium in an antibiotic susceptibility test proved to be resistant to all of the antibiotics tested

    Improving antimicrobial stewardship Video Subscription

    Improve your practice and slow the increasing levels of antimicrobial resistance that already cost around 25,000 deaths across Europe each year.

  • Pills (Klenova/

    Why are there so few antibiotics in the research and development pipeline? Subscription

    Elizabeth Sukkar finds out that there are a number of incentives to aid the development of new antibiotics. But will society be prepared to pay the price?

  • New initiatives to reduce antibiotic use Subscription

    Excessive and inappropriate use of antibiotics is considered to be the most important cause of bacterial resistance1 and a number of studies published have shown a relationship between antibiotic prescribing and the development of resistance, including two key studies within primary care.

  • Current treatments for resistant infections Subscription

    Enterobacteriaceae are a family of Gram negative rods, the medically important members of which can be found in the lower gastrointestinal tract of humans and animals as well as in soil and water (see Panel 1). These organisms can be involved ...

  • Which antibiotics and vaccines should be used for meningococcal disease? Subscription

    A local GP has telephoned to arrange for a four-year-old boy to be admitted to the paediatric ward with suspected meningitis. The child has had a fever, loss of appetite and nausea since yesterday but in the past four hours his condition has deteriorated.

  • Understanding antibiotic resistance Subscription

    Antibiotic resistance can be described as microbiological or clinical. Microbiological resistance exists when an organism possesses any resistance mechanism (see Panel 1 for examples). Clinical resistance can be explained as failure to achieve a concentration of antimicrobial that inhibits the growth of the organism in a particular tissue or fluid.

  • The right drug for the right bug Subscription

    By Hayley Wickens and Paul Wade

  • How to screen an antibiotic prescription Subscription

    You are new to the ward and many of your patients are prescribed antibiotics. Here are some tips to help you check the therapy is apt

  • Delayed antibiotics does not reduce long-term reconsultation (POEM) Subscription

    Clinical question: Does delayed antibiotic prescribing for acute respiratory infections reduce the rate of consultation for subsequent respiratory infections?

  • Spotlight on medicines: Doripenem Subscription

    While media attention focuses on battling MRSA and C diff, some strains of Gram-negative bacteria have developed resistance to many antibiotics. A new carbapenem is a useful addition to the arsenal

  • Infectious diseases - the need for new antibiotics Subscription

    What went wrong with antibiotics, was a question posed in a leading article in the BMJ. It offered suggestions on ways to promote the rational use of antibiotics in order to stem the development of microbial resistance and to save money.This article appeared in 1984.1

  • Antimicrobial management - mechanisms of acquired resistance Subscription

    The use of antibiotics for treating bacterial infections is based on the fact that they exhibit selective toxicity. That is to say, they inhibit or kill bacteria but usually have minimal or no adverse effects on the cells or tissues of the infected host.

  • Antimicrobial management - the role of clinical pharmacists Subscription

    Micro-organisms resistant to antimicrobials, especially those with multiple resistances, are causing concerns within health care systems throughout the world. Infections become more difficult to treat and patients stay longer in hospital, with the associated increases in costs. Furthermore, because less safe antimicrobial agents have to be used when the more safe alternatives are no longer suitable due to resistance, the prevalence of unwanted effects of the medicines tends to increase

  • Time to review short courses of antibiotics Subscription

    Edward C. F. Wilson, MSc, is lecturer in health economics, Health Economics Group, School of Medicine, Health Policy and Practice, University of East Anglia, Norwich.John V. Wilson, MRPharmS, FRSPH, is pharmacist (retired) and former regional prescribing adviser, NHS Executive, Trent.

  • CPD logo

    Peri-operative antibacterial prophylaxis Subscription

    When is peri-operative antibacterial prophylaxis appropriate?

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