We all have a role to play in fighting antimicrobial resistance

This week is Antibiotic Awareness Week and Mark Gilchrist, consultant pharmacist at Imperial College Healthcare NHS Trust, is leading efforts to educate staff and patients about the safest, most effective ways to use antibiotics, and about antimicrobial resistance, or resistance to antibiotics by bacteria that cause illnesses including urinary, blood and wound infections. Here, he explains what we’re doing at the Trust and how you can help tackle this challenge.

Ever since Sir Alexander Fleming discovered penicillin in his lab at St Mary’s Hospital in 1928, we’ve relied on antibiotics to treat a host of illnesses caused by bacteria, from simple urinary tract infections to life-threatening sepsis.

But our overuse or misuse of antibiotics over recent years has led to some bacteria becoming resistant to them. In essence, some of the antibiotics we once grabbed from our shelves don’t work anymore and this can lead to challenges when we need to treat patients who have an infection. Unfortunately there are very few new antibiotics in the development pipeline, which is why we need to act now to preserve the antibiotics we still have available.

At our Trust, we are trying to help tackle the threat of antimicrobial resistance everywhere we can, from our patients’ bedsides to our leading research units. We have published our antibiotic guidelines for adults and children in an app for smartphones so that medical and non-medical prescribers such as nurses and pharmacists have access to them at the point of prescribing.

Our infection teams, including infectious diseases, microbiology, infection pharmacists, review patients, undertake ward rounds and help colleagues advise on the most appropriate antibiotic regimens for each patient. It’s important to find the right balance when prescribing antibiotics, as broad-spectrum antibiotics attack both harmful and beneficial bacteria, which can contribute to resistance. That’s why our microbiology laboratory helps process samples quickly to ensure that any broad-spectrum therapy can be targeted once the bacteria causing the infection has been identified. We also have dedicated committees to help monitor and review antibiotic use and resistance patterns. These teams work in partnership with our infection prevention and control (IPC) colleagues to ensure IPC principles are at the heart of antimicrobial prescribing and decision making.

An important aspect to antimicrobial resistance is undertaking research and we work very closely with our academic partners at Imperial College to help translate this research into improved patient care, not only within secondary care but with our primary care colleagues as well.

Advanced research and prudent prescribing are at the heart of the fight against antimicrobial resistance, but we all have a role to play in raising awareness about the safest way to use and prescribe antibiotics. At our Trust, we’re marking World Antibiotic Awareness Week (14-18 November) with a week-long campaign to raise awareness of some of the key points and actions around antimicrobial resistance.

We’re reminding staff to always take microbiology samples before starting antibiotics and ensuring the results are reviewed, altering therapy as appropriate, documenting why antibiotics have been started with a review date recorded and promoting the government’s “start smart then focus” principles around antibiotics.

For patients, it is important that antibiotics are taken as prescribed and not shared with friends or families. All medicines have side effects but if you feel that the antibiotic is not agreeing with you then seek help and advice from a healthcare professional – don’t stop taking them without first speaking to your doctor.

Our Trust is also hosting an antibiotic amnesty programme during this week. We encourage all patients, visitors and staff to visit Lloyds pharmacies at our hospitals and drop your unused antibiotics off at our pharmacies – we’ll safely dispose of all donated antibiotics.

Finally, everyone – including healthcare professionals and patients – can pledge to become antibiotic guardians. Antibiotic guardians can pledge to do one simple thing which is to use antibiotics safely and effectively in their personal and professional lives.

Tackling antimicrobial resistance is a partnership and we all have to work together to ensure we use antibiotics responsibly. It is important we use the right antibiotic, at the right dose, at the right time for the right duration. Our health depends on us all taking action, together.