Fireside Chat on Antimicrobial Resistance and Stewardship

In our latest fireside chat, we talk to Dr Simon Hendricks (Product Manager, Innovation), and Tony Dilks (Clinical Strategist) about antimicrobial resistance (AMR) and stewardship, and what we’re doing here at FDB.

What is AMR? 
Antimicrobial Resistance (AMR) is a prominent topic in the healthcare industry and has been for some time. It is a focus for healthcare media and national and international organisations, because of the impact of new strains and the poor prescribing of antibiotics that have exacerbated the problem in the UK and across the globe. This is a serious issue that means longer stays in hospital, increases in cost of treatments and degradation of the health and wellbeing of the patient. 

We are going to look at what national and international bodies are actively working on to tackle this.

We recently attended the Clinical Pharmacy Congress, where we watched Kieran Hand, the AMR National Pharmacy and Prescribing Clinical Lead at NHS England and NHS Improvement, present on ‘Antimicrobial Stewardship Beyond the Pandemic’. Within his talk, Kieran talked about a spike in prescribing antibiotics in primary care in April 2020 which links with the onset of pandemic. He also went into detail about the National AMR Action Plan, ‘Tackling antimicrobial resistance 2019–2024’ which has clear improvement goals.

Within the report, the authors state: ‘Antimicrobial resistance (AMR) is a global problem that impacts all countries and all people, regardless of their wealth or status. The scale of the AMR threat, and the need to contain and control it, is widely acknowledged by country governments, international agencies, researchers and private companies alike.’ 

The action plan is set out in this document, which looks at tackling AMR in the UK and further afield. The plan was developed in consultation with a broad range of stakeholders across different sectors and builds on the achievements of the last strategy (2013–2018) and is aligned with global plans and frameworks for action. ‘The plan has ultimately been designed to ensure progress towards our 20-year vision on AMR, in which resistance is effectively contained and controlled. It focuses on three key ways of tackling AMR.’  These are:

• reducing need for, and unintentional exposure to, antimicrobials;
• optimising use of antimicrobials; 
• investing in innovation, supply and access

What is being done about AMR? 
Appropriate prescribing needs to be encouraged so the right and antibiotic is being used to treat the infection, but the trend seems to have been changing recently. With C. diff and VRE still an issue in hospitals, hospitals must be acutely aware of AMR and better testing of patients to target the infection with the right drug.  

So, changes are needed in prescribing behaviour ensuring that patients are swabbed to identify the infection and prescribing more suitable drugs to treat the infection.

What could FDB be doing about AMR?
At FDB, we have been doing some serious research into how we can help tackle this problem. Simon Hendricks explains: 

‘The key to this issue is really about understanding more about the prescribing event to help support the clinician in making an informed prescribing decision - knowing more about the patient and about the potential type and level of infection, knowing whether the patient is amenable to antibiotics or not, and whether they’ve been prescribed or are currently on antibiotics (or other medications that may impact the effectiveness of some antibiotics).  

We need to be looking at how we are providing the clinician with the right information so that they can select the most appropriate time frame for narrow spectrum antibiotics and target the infection.  We’d be looking at solutions that can help limit the use of antimicrobials to start with, selecting one that is as narrow spectrum as possible and for a shorter period. For us to do all of this, we have to understand as much as we can about the patient - consuming more data about patient context and the environment that the patient is being treated within will enable us to deliver more intelligent and informed solutions to the clinician.’

What are YOU doing about AMR? 
We are talking to some of our customers about AMR – please get in touch if you want to find out more – we’d really be interested in your thoughts, plans and how we can work with our vendor partners and end users to support improved prescribing in this area.