Antimicrobial Chemotherapy by Finch Roger; Davey Peter; Wilcox Mark H

Author:Finch, Roger; Davey, Peter; Wilcox, Mark H.
Language: eng
Format: epub
Publisher: Oxford University Press
Published: 2012-04-11T04:00:00+00:00

Antibiotic stewardship at the population level

The principles of antibiotic stewardship are described in Chapter 20. The European Commission prepared a comprehensive Community strategy against antimicrobial resistance in 2001. At that time only six European countries had a national action plan to contain antimicrobial resistance. By 2003, 16 countries had developed a national strategy to contain antimicrobial resistance and by 2008, 23 (85%) of 27 countries had an action plan for management of antimicrobial resistance. There is evidence of success in reduction of infections caused by MRSA and C, difficile in European countries. European Surveillance of Antimicrobial Consumption (ESAC) has developed methods for sustainable measurement of prescribing and indicators of prescribing quality. In Scotland the ESAC indicators were adopted in 2009 as national targets to support reduction in C, difficile infection. In hospitals there has been a steady increase in the number of participating hospital units and in their compliance with local antibiotic policies (Fig. 19.3) and in primary care there has been a 20% reduction in use of antibiotics associated with C, difficile infection (Fig. 19.4) since 2009. These changes in prescribing were associated with 42% reduction in C, difficile infection in persons aged 65 and over between October 2008–September 2009 and October 2009–September 2010 (http://www.hps.scot.nhs.uk/haiic/sshaip/wrdetail.aspx?id=46771&wrtype=6).

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