The Scottish Management of Antimicrobial resistance Action Plan 2014 – 18 (ScotMARAP 2) is a sub-national cross-sectoral plan. Its main objectives are to identify and reassure patients who do not require antibiotics; promptly identify patients who require antibiotics and in patients with sepsis syndrome start treatment within one hour; obtain cultures (where appropriate) prior to starting antibiotics; do not give antibiotics with overlapping activity or combinations not supported by evidence or guidelines; determine and verify antibiotic allergies and tailor therapy accordingly; consider local antibiotic susceptibility patterns in selecting therapy; start treatment promptly following local guidelines; specify expected duration of therapy based on evidence and national and local guidelines; clearly identify currently prescribed antibiotics, indication for treatment, start dates and intended duration or review date for each patient at the point of care; give antibiotics at the right dose and interval; stop or de-escalate therapy promptly based on culture and sensitivity results; consider role of biomarkers; ensure therapeutic drug monitoring and dosage adjustment is carried out reliably; reconcile and adjust antibiotics at all transitions and changes in patient’s condition; consider need for use of IV route throughout the patient’s episode of treatment; monitor for toxicity reliably and adjust agent and/or dose promptly when required; establish stewardship as an organisational priority, ensure resources are made available and identify accountability; ensure local structures for antimicrobial stewardship and links to management, infection prevention and control and patient safety are in place; monitor, feedback, and make visible data regarding antibiotic utilisation, antibiotic resistance, ADEs, CDI, cost, and adherence to the organisation’s recommended microbiology and prescribing practices; ensure national and local education programmes on antimicrobial stewardship meet the training needs of health and care staff and promote patient and public awareness about use of antimicrobials; develop and make available multi-professional expertise in antimicrobial use; and ensure expertise is available at the point of care across all health and care settings.
Royaume-Uni de Grande-Bretagne et d'Irlande du Nord · 2014-07-01