Antimicrobial prescription appropriateness was assessed by twice weekly multidisciplinary Antimicrobial Management Team (AMT) ward rounds. This information was then inserted into a Microsoft Access® database in order to report results. This information was then circulated to all prescribers and pharmacists
on a quarterly basis in the form of a detailed report. A total of 2,273 antimicrobial prescriptions across 17 wards were reviewed by the PPS. From this analysis clinical indication and duration/review date were documented on 49.2% and 80.6% drug charts, respectively, with only one ward scoring above 85% in both. A total of 558 patients were reviewed across the 17 wards by the AMT.
Overall compliance with local guidelines to the appropriate choice of antibiotic was adhered to in 91% of cases. However, 62% of the antimicrobial prescriptions were considered C59 wnt ic50 appropriate. The remainder were considered inappropriate due to unnecessary prolongation of duration, lack of compliance with local guidance and no clinical need for antimicrobials. Overall, compliance with local and national AS recommendations was poor. Daporinad chemical structure A lack of documentation of indication and duration/review dates of antimicrobials at the time of prescribing meant that not all antimicrobials had been reviewed in a timely manner. A specifically designed antimicrobial prescribing section on the Trust drug Anidulafungin (LY303366) chart embracing ‘Start smart- then focus’; principles has been recommended. Stringent monitoring by antimicrobial pharmacists and better feedback to medical teams on their compliance to both local and national guidance is recommended to improve compliance. 1. Department of Health. Antimicrobial stewardship: “Start Smart – then Focus” Guidance for antimicrobial
stewardship in hospitals (England). Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infection (ARHAI). November, 2011. www.fadelibrary.org.uk/wp/wp-content/uploads/downloads/2012/01/Antimicrobial-stewardship-Start-smart-then-focus-Resource-Tools.pdf G. Hardinga, M. Wilcockb, J. Lawrenceb, J. Blundellb aPeninsula College of Medicine and Dentistry, Exeter, UK, bRoyal Cornwall Hospitals NHS Trust, Truro,Cornwall, UK Focus group of Foundation Year One (F1) doctors was convened during their induction programme to understand their beliefs and expectations regarding safe prescribing practice. Their main concern was with appropriate prescribing in the context of the individual patient’s circumstances. For pharmacists to be a valuable resource, they need to forge strong links early on with the F1s. Prescribing errors are common; with junior doctors noted to be at high risk of making such errors.