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Chief Nurse's Blog

Chief Nurse’s Blog

Date of release: 17 November 2020

Latest News: Ann-Marie Cannaby Blog

I’m kicking off this blog by declaring I’ve made my pledge to become an Antibiotic Guardian at the Antibiotic Guardian Website.

You might ask what I’m referring to. I have made a pledge because I believe it is vital to keep our precious antibiotics working.

Public Health England established the Antibiotic Guardian campaign in 2014 to help protect antibiotics and improve knowledge about antibiotic resistance.

Antibiotic resistance is one of the biggest threats facing us today. Without effective antibiotics, many routine treatments will become increasingly dangerous. 

Setting broken bones, routine operations, even chemotherapy and animal health all rely on access to antibiotics that work.

To slow resistance we need to reduce the unnecessary use of antibiotics, and that when we do use them, we use them appropriately. 

We invite the public, students and educators, farmers, the veterinary and medical communities and professional organisations, to become Antibiotic Guardians.

This year, the COVID-19 pandemic has presented numerous additional challenges for health professionals managing patients with infections. 

Now, more than ever we need to continue to work together to prevent serious infections – including COVID-19 – while reducing inappropriate antibiotic use. 

Antibiotics kill bacteria that cause infections. When bacteria see or are exposed to antibiotics, because they want to survive, they come up with ways to stop the antibiotic getting into the bacteria, or stop it from working as it should.  

There are many mechanisms that can be used by the bacteria, to stop them being affected by the antibiotics.

So, if we overuse antibiotics by:
  • Prescribing them when they are not needed (eg no infection present)
  • Give them for too long
  • Use of broad spectrum antibiotics that cover many species of bacteria, not the one we want to treat

This will lead to the bacteria becoming clever to overcome them, so when a serious infection occurs, the antibiotics do not work.  

Patients die all over the world because of this. Resistance to antibiotics is a global health disaster that is already killing 700,000 people a year, and it is predicted to cause 10 million deaths per year by 2050 if the current situation is not improved.

Prescribing antibiotics appropriately means we don’t give the bacteria an opportunity to become resistant.

Also, imagine a bowl full of bacteria. If we pour an antibiotic that kills many types of bacteria on top, most of the bacteria die, leaving behind one or two already resistant strains that may have got there years ago, but were being kept in check.  

Now those one or two have all the space, all the food and no competition, so they spread and take over. Because they are resistant, they are difficult or impossible to treat when they cause an infection.

Remember, we have more bacteria cells in our body than human cells, so we need each other – just not the ‘nasty’ resistant ones, and not in places they should not be in.

The antibiotic guardian website encourages people to make a pledge to use antibiotics sensibly, and not over use them. Completion rates of these are then viewed by PHE.

World Antimicrobial Awareness Week (WAAW) aims to increase awareness of global antimicrobial resistance (AMR) and to encourage best practices among the general public, health workers and policy makers to avoid the further emergence and spread of drug-resistant infections. 

This year the focus for WAAW and European Antibiotic Awareness Day (EAAD), in England is on health and social care workers. Raising awareness of the risks of antimicrobial resistance remains important. 

However, considering the challenges of responding to the ongoing COVID-19 pandemic, it is important to follow the guidelines below to avoid inappropriate antibiotic prescribing.

Antibiotics should be prescribed in line with the Trust antimicrobial prescribing guidelines. We want to keep resistance to antibiotics down, and we can do this by:
  • Review any empirical antibiotics within 72 hours, and stop them if there is no sign of bacterial infection
  • Ensure all prescribing decisions are clear and timely
  • Documenting all prescribing decisions clearly on the prescription and in the medical notes
  • Switching from IV to oral antibiotics as soon as appropriate
  • Choose a pledge or renew a pledge on the Antibiotic Guardian website and ask another five people to do the same.

This is something we can measure, so within the Clinical Commissioning Group (CCG) we can see how many new pledges have been made.

Finally, I want to mention Care to Share, our publication by nurses for nurses.

The latest edition, which was produced last week, features the reflections of COVID-19 from members of staff.

It’s fabulous and I am really proud of the contributions so many of you have made.

I know the magazine is read right across the organisation by clinicians and non clinicians alike, and I thank all of you who have contributed to make it such an interesting read.

Well done!

Take care,

A Teaching Trust of the University of Birmingham