The first inaugural Antibiotic Guardian awards took place on 12th May 2016 to celebrate the work of healthcare professionals across England in tackling antimicrobial resistance. These awards form part of the ongoing Antibiotic Guardian campaign which is led by Public Health England in collaboration with UK devolved administrations and professional bodies.
The evening was attended by healthcare organisations across England who had all submitted entries and then shortlisted for their achievements in work to help combat antibiotic resistance and protect antibiotic usage. Awards were given in the following categories: Community Engagement, Stewardship, Innovation, Collaboration, Prescribing and Research and Staff Engagement and jointly presented by Deputy Chief Medical Officer for England, Professor John Watson and Dr Diane Ashiru-Oredope (lead for the Antibiotic Guardian campaign and Pharmacist Lead for the AMR Programme at Public Health England)
Dr Diane Ashiru-Oredope, Lead for the Antibiotic Guardian campaign, said:
“The Antibiotic Guardian awards are an excellent opportunity for us to champion organisations and individuals who have supported the Antibiotic Guardian campaign and demonstrated achievement in their work to tackle antimicrobial resistance, one of the biggest global public health threats we face.
“These awards have highlighted the wealth of fantastic work taking place across the country in combating antimicrobial resistance. I’d like to personally congratulate all the nominees and winners for their contributions.
“At Public Health England we will continue to support and work with partners across the health system to improve antimicrobial prescribing and stewardship programmes.”
The four neighbouring CCGs across South West Yorkshire worked in partnership to develop Antimicrobial Guidelines for use in Primary Care. A multi-disciplinary/multi-organisation working group was formed in April 2015 with the remit of developing an antibiotic campaign to reduce unnecessary prescribing of antibiotics. All four CCGs have made significant reductions in the last few years in the volume of Cephalosporin and Quinolone antibiotics used and have managed to maintain levels well below the England average for over two years.
The CCG’s have also carried out a great amount of public engagement, including a live radio broadcast was aired on European Antibiotic Awareness, in which 62 messages came in during the first hour of the show and the broadcast was recorded on the radio YouTube channel and has been viewed 481 times to date, with the station receiving more broadcasts to be delivered like this in the future.
This mental health and community health services Trust has developed and introduced a number of resources, including the smart phone app the Microguide, and a bespoke e-learning module. The app was launched and promoted using a variety of methods, including computer screensavers during the week leading up to EAAD, a pharmacy team promotional video-clip of the team supporting Antibiotic Guardianship, promotional stands across all trust hospital sites in the county, face to face education sessions at ward level for all clinical staff. A trust-wide re-audit of inpatient prescription was carried out after the interventions above were made and the results showed significant improvements in most standards audited, with 2 out of 8 standards being 100%.
Devon County Council Public Health led a partnership with North East West Devon Clinical Commissioning Group, Northern Devon Healthcare NHS Trust and the Devon Local Pharmaceutical Committee to develop a pilot social marketing intervention aimed at low income parents to reduce demand for antibiotics.
The project took a different approach to reaching the community and this was dictated by the parents
themselves with the focus groups.
Parents were driven by digital advertising and social media to the video on the Childrens Centre Facebook page and YouTube and Listen to your gut linked up with the Public Health England Antibiotic Guardian campaign to capitalise on national coverage in the lead up to European Antibiotic Awareness Day on 18 November. YouTube pages were linked and the online traffic peaked during this time.
The evaluation in 2014 showed:
In the summer of 2015 a new Pharmacist joined the North Kirklees CCG Medicines Management team use his contacts in the area to facilitate and deliver educational sessions the community, including in the local mosques.
He met with the antibiotic project group and put forward a proposition that he would:
Some of the outcomes of the project include:
A range of interventions were set up by the CCGs including educational meetings for GPs and clinicians; the provision of support materials aimed at empowering avoidance or delayed antibiotic prescribing, where appropriate, and improving patients’ knowledge and confidence in self-management; as well as the production of different treatment guidelines incorporating key messages with evidence, indicating where antibiotics are unlikely to be of benefit.
Some of the outcomes achieved were as follows:
The NIHR Health Protection Research Unit (HPRU) in HCAI and AMR at Imperial College held an Antibiotic Amnesty from Monday 16th November until 20th November 2015.
The Amnesty raised a huge amount of awareness for World Antibiotic Awareness Week and the Antibiotic Guardian programme.
By hosting the stands over lunchtime at 2 of the College’s busiest campuses in addition to organizing coverage on the College and Trust websites, we ensured that a signification proportion of the College’s 14,700 students and 8,000 staff were made aware of these schemes even if they did not participate in the event itself.
The teams manning the stands including Fran Husson a patient/public rep, engaged in over 200 separate conversations with staff and students about antibiotic resistance, what is means to us all and what they can do about it- starting with handing in unwanted antibiotics and pledging to become a Guardian. Fact sheets and other information were handed out to hundreds of people.
The Amnesty saw a range of antibiotics including Amoxicillin, Doxycycline, Phenoxymethylpenicillin, Flucloxacillin and Co-amoxiclav surrendered for disposal including some from overseas. Over 204 people signed up to become an antibiotic guardian.
The Medicines Optimisation Team at Leicester City CCG in 2013 embarked on a journey to join the global project in tackling antimicrobial resistance, locally engaging key stakeholders to lead and establishing robust antibiotic stewardship. Activities included reviewing local antimicrobial policies and guidances, driving the agenda for change in primary care guidance, raising awareness of the guidance, and engaging with patients.
Some of the outcomes achieved:
The project involved a multifaceted approach to reducing inappropriate antibiotic prescribing in the GP practices within NHS Nene CCG. This work has resulted in improved performance according to the antimicrobial indicators in the Quality premium, with reduction in both overall antibiotic use and specifically, use of co-amoxiclav, cephalosporins and quinolones
Some of the initiatives implemented include:
1) the promotion of the antimicrobial markers within the Quality Premium to GP practices.
2) A 6 month pilot of point-of-care CRP testing in the 7 GP practices with the highest antibiotic prescribing is being undertaken.
3) undertaking audits of co-amoxiclav use by community nurses and podiatrists
4) Sessions on antimicrobial stewardship were delivered to non-medical prescribers across the CCG
5) The development of a prescribing newsletter, which is circulated to GPs, nurses, community pharmacists and the acute trusts
The Australian-based Community for Open Antimicrobial Drug Discovery (CO-ADD) was set up to develop a collaborative pipeline of new antibiotic candidates by mining the diverse chemical space of synthetic chemists around the world.
In 12 months, 35,000 academic compounds have been screened from 88 research institutions in 26 countries, and over 300,000 additional compounds have been promised, showing the successful uptake of the program by the academic community.
They have been involved in running and hosting a panel discussion on the BIO 2016 Convention in San Francisco on panel of key experts to address the critical issue of anti-infective development and the need for global alignment of global anti-infective research and development to the patient, as well as well as running numerous antibiotic resistance events in Australia for general public awareness.
For European Antibiotic Awareness Day 2015, the UHS antimicrobial stewardship team enlisted the help of our pre-registration pharmacists to promote careful use of antibiotics to staff, patients and visitors to our hospital. We arranged and staffed a stand outside the hospital restaurant, providing information on our local use of antimicrobials and public health messages around appropriate antimicrobial prescribing; we helped 76 people to make their Antibiotic Guardian pledge on the day, using laptops on the stall, and promoted the campaign to many more.
The team also visited wards throughout the hospital, speaking to over 150 clinical staff, using a specially-designed flyer showing how our local prescribing compares to national data, and promoting our local antibiotic guideline smartphone app. The team ran a stewardship-themed crossword competition, as well as a social media campaign on Twitter and Facebook, a poster campaign throughout the Trust, changing all computer screensavers throughout the Trust to carry antibiotic stewardship messages, and presenting on antibiotic stewardship at the Trust-wide Grand Rounds meeting that week.
The Pharmaceutical Public Health Team in Dudley under took a key project to engage staff in antibiotic stewardship, by focussing staff and GP member engagement activities.
North of England Commissioning Unit have been successful in developing an accessible toolkit of antimicrobial prescribing resources and interventions to support doctors, nurses, OOH services and other primary care clinicians in the rational use of antibiotics across the North East and Cumbria.
As a result of the numerous interventions, some of the outcomes achieved include:
The Trust has been successful in developing a Respiratory Infections Team based in the acute admission areas, which reviews all adults admitted between Monday and Friday with suspected community-acquired pneumonia. Point-of-care microbiological testing for influenza PCR and urinary pneumococcal and legionella antigens was possible in 93% of appropriate patients. To date, 43% of patients reviewed by the service have had a positive microbiological diagnosis made, which has led to the admitting medical teams streamlining antibiotic regimens in 19%. As results are generated within the acute admission areas, there has also been a reduction in the time taken for a microbiological diagnosis to be made, allowing an appropriate targeted antibiotic to be chosen early in the admission episode.
The service has also been valuable in providing a rapid influenza diagnosis, which has enable IPC teams to make rapid decisions as to whether patients need isolation and respiratory viral precautions
The second Antibiotic Guardian awards will be hosted in 2017