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NOV 25/2013

Antibiotic resistance - a game-changer for NHS organisations

For anyone working in nursing and care roles within the NHS, antibiotic resistance is a subject they will have been hearing a lot about recently, as people at all levels within the health service engage in discussions about how to tackle this dangerous trend.

This hot topic of debate has taken on an even more prominent role in the public consciousness over the last few days due to European Antibiotic Awareness Day - an annual initiative organised by the European Centre for Disease Prevention and Control - having taken place for the sixth time on November 18th 2013.

The problem is simple to understand, but difficult to address. In the last few decades, hospitals in the UK and elsewhere in the world have seen an inexorable rise in the number of so-called superbugs, which are bacterial and viral infections that are resistant to most common forms of antibiotic therapy.

Virulent organisms such as MRSA, Pseudomonas aeruginosa, C. difficile, salmonella and E. coli can proliferate in healthcare settings, putting the health of patients at risk. If left unchecked, the spread of these superbugs could mean many routine medical procedures become too risky to perform - potentially setting healthcare provision in the UK back by decades.

As such, government and NHS leaders have allied to call for a united effort to tackle this problem head on. A five-year antimicrobial resistance strategy was announced in September 2013 by the Department of Health, which will encompass widespread efforts to better prevent and manage infections, including through improved hygiene and monitoring of bacteria in medical and community settings.

Better data on the resistance of bugs needs to be collated so they can be tracked more effectively, while pharmaceutical companies will be encouraged to dedicating more resources to researching new antimicrobial agents.

However, it is healthcare providers who can play perhaps the largest role in tackling this problem. After all, it is understood that an overreliance on the use of antibiotics by doctors in the past has accelerated the current situation, with a recent study from Cardiff University revealing that antibiotic therapies have often been used unnecessarily to treat conditions such as coughs.

As such, Public Health England is emphasising the need to keep antibiotic prescription to a minimum over the coming winter months, underlining the message that sore throats, runny noses, earache, colds and flu-like illnesses can be managed with over-the-counter medicines.

This means many patients who are currently seeking treatment from GPs or emergency care providers could be handled just as effectively by community pharmacists - leading the National Pharmacy Association to call upon those in the sector to provide stewardship on this issue.

Meanwhile, the Royal College of Nursing (RCN) and the Royal College of GPs are among the many healthcare industry bodies highlighting the need to educate staff on the importance of avoiding the use of antibiotics unless absolutely necessary.

These efforts will also encompass the need to dispel certain myths surrounding antibiotics among patients, many of whom regularly consult GPs with an expectation that these treatments should and will be prescribed to them.

Rose Gallagher, the RCN's infection prevention and control adviser, said: "We all need to consider what we can do the reduce the very real threat of resistance. As the largest part of the health workforce, nursing staff carry significant influence and are key knowledge-brokers for patients."

"We support patient education on living well and explain why prescribing antibiotics may not be necessary, we promote and give vaccinations, and we are integral to infection prevention and control strategies."

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