An investigation into factors affecting the implementation of Antimicrobial Stewardship (AMS) before and during the COVID-19 pandemic in two acute care settings

This study investigates the factors impacting the implementation of Antimicrobial Stewardship (AMS) before and during the COVID-19 pandemic across two acute care settings. Utilising storytelling to enhance the impact of the research, the study focuses on the dual challenges posed by COVID-19 and Antimicrobial Resistance (AMR). The research highlights the importance of effective AMS to address both viral and bacterial threats. It presents a "tale of two pandemics," examining how COVID-19 and AMR intersect and complicate treatment protocols. The study emphasises the crucial role of AMS in maintaining the appropriate and effective use of antibiotics, which are vital in preventing infections and preserving their efficacy. Key factors affecting antibiotic use, both before and during the pandemic, are explored through the perspectives of healthcare professionals. By leveraging storytelling, the research aims to communicate complex issues in a more engaging and relatable manner, thereby increasing the understanding and impact of AMS principles. The study provides practical recommendations to enhance patient care safety and quality, ensuring that AMS practices are upheld even in the face of unprecedented healthcare challenges. By addressing these factors, the study contributes to ongoing efforts to improve AMS implementation, ultimately safeguarding public health against the threats of AMR and future pandemics.Peer reviewe

WHO AWaRe Classification for Antibiotic Stewardship: Tackling Antimicrobial Resistance - A Descriptive Study from an English NHS Foundation Trust Prior to and During the COVID-19 Pandemic

© 2023 Abdelsalam Elshenawy, Umaru and Aslanpour. This is an open-access accepted manuscript version of an article which has been published in final form at https://doi.org/10.3389/fmicb.2023.1298858Antimicrobial resistance (AMR) is a silent and rapidly escalating pandemic, presenting a critical challenge to global health security. During the pandemic, this study was undertaken at a NHS Foundation Trust in the United Kingdom to explore antibiotic prescribing trends for respiratory tract infections (RTIs), including pneumonia, and the COVID-19 pandemic across the years 2019 and 2020. This study, guided by the WHO’s AWaRe classification, sought to understand the impact of the pandemic on antibiotic prescribing and antimicrobial stewardship (AMS). The research methodology involved a retrospective review of medical records from adults aged 25 and older admitted with RTIs, including pneumonia, in 2019 and 2020. The application of the AWaRe classification enabled a structured description of antibiotic use. The study evaluated antibiotic use in 640 patients with RTIs. Notably, it observed a slight increase in the use of amoxicillin/clavulanic acid and a substantial rise in azithromycin prescriptions, highlighting shifts in prescribing trends. Despite these changes, some antibiotics displayed steady consumption rates. These findings highlight the importance of understanding antibiotic use patterns during the AMR threat. The increase in the usage of “Watch” category antibiotics during the pandemic emphasises the urgency of robust AMS measures. The research confirms that incorporating the AWaRe classification in prescribing decisions is crucial for patient safety and combating antibiotic misuse. This study provides essential insights into the changing landscape of antibiotic prescribing during a global health crisis, reinforcing the necessity for ongoing AMS vigilance to effectively address AMR challenges.Peer reviewe

Report: Optimising Antimicrobial Use During the COVID-19 Pandemic in UK Acute Care Settings (2020-2024) – Insights from Three Sequential Studies

This report presents findings from a comprehensive research project conducted in UK acute care settings, encompassing three sequential investigations. These studies included a systematic review of key antimicrobial stewardship (AMS) strategies, an analysis of patient records to observe shifts in antibiotic prescribing patterns, and a survey of healthcare professionals. The results highlighted the critical role of multidisciplinary teams in AMS (93%), an increase in inappropriate antibiotic prescribing, and significant disruptions in AMS activities during the pandemic. These findings underscore the urgent need for resilient and strategic AMS adaptations to optimise antimicrobial use, combat antimicrobial resistance, and enhance patient care and quality of life. Additionally, this research proposed practical tools for effective AMS implementation, such as the AMS framework or roadmap for implementation at both patient and organisational levels, an AMS dynamic dashboard, AMS cards, and an AMS educational programme. These tools aim to improve antibiotic prescribing and stewardship, integrate seamlessly with various systems, and offer practical solutions to antimicrobial resistance, ultimately safeguarding public health and saving patient lives. By advancing AMS practices, this project contributes to the global effort to optimise antibiotic use and improve healthcare outcomes

An evaluation of the types and contributing factors of dispensing errors in hospital pharmacy

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Medicines Related Problems (MRPs) originating in Primary care settings in Older Adults - A Systematic Review

© The Author(s) 2021. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/)Background: As people age, they become increasingly vulnerable to the untoward effects of medicines due to changes in body systems. These may result in medicines related problems (MRPs) and consequent decline or deterioration in health. Aim: To identify MRPs, indicators of deterioration associated with these MRPs, and preventative interventions from the literature. Design and Setting: Systematic review of primary studies on MRPs originating in Primary Care in older people. Methods: Relevant studies published between 2001 and April 2018 were obtained from Medline (via PubMed), CINAHL, Embase, Psych Info, PASCAL, Scopus, Cochrane Library, Science Direct, and Zetoc. Falls, delirium, pressure ulcer, hospitalization, use of health services and death were agreed indicators of deterioration. The methodological quality of included studies was assessed using the Down and Black tool. Results: There were 1858 articles retrieved from the data bases. Out of these, 21 full text articles met inclusion criteria for the review. MRPs identified were medication error, potentially inappropriate medicines, adverse drug reaction and non-adherence. These were associated with indicators of deterioration. Interventions that involved doctors, pharmacists and patients in planning and implementation yielded benefits in halting MRPs. Conclusion: This Systematic review summarizes MRPs and associated indicators of deterioration. Appropriate interventions appeared to be effective against certain MRPs and their consequences. Further studies to explore deterioration presented in this systematic review is imperative.Peer reviewe

Development of a Consumer Reported Outcome Measure for Personal Care Products : The Rationale

© 2024 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/Background: Cosmetic products are one of the fastest-growing segments of personal care products in the United States. One of the critical elements in the sales and growth of cosmetics is leveraging claims. Unlike pharmaceuticals in the US, claims in personal care products are usually not reviewed nor require regulatory approvals before products are sold in the US. However, regulatory agencies have no oversight of how the advertisement is presented to the consumers and have cited known companies and brands for promoting deceptive advertising and forcing costly market withdrawal, impacting the financial values of investors and customers' confidence alike. Objectives: We conducted a literature search and a survey. The literature search was to identify the current methodologies available for substantiating the advertisement of personal care products (including cosmetics). The survey was conducted with regulatory professionals aiming to understand the use of the current methodologies. Methods: The survey was developed and distributed to regulatory professionals in different capacities within the Cosmetic and Personal Care industry who had extensive experience constructing and substantiating advertising claims regulatory for cosmetic and personal care products. The questionnaire comprised 9 questions with socio-demographic characteristics and regulatory experience validating claims. Results: We received 63 responses from 1354 forms sent from regulatory professionals validating advertising claims. The results show that 85 % of the respondents use the FDA guidance while the remaining 15 % use in-house or other non-governmental guides. Moreover, 58 % use some Risk Benefit, while 42 % do not use it when evaluating claim substantiation. Conclusion: Although the respondents qualifying the claims possess the experience and technical knowledge of Cosmetic and Personal Care Products, the presently available standards used in the US are not designed to validate the substantiation of advertising claims. Therefore, there is a need to develop a more robust methodology for the evaluation of the validation and substantiation of advertising claims. A technique of using personal experiences is already approved and used for pharmaceutical products known as Personal Reported Outcomes (PRO). Leveraging the PRO techniques can help develop a “consumer reported outcome measure” (CROM) tool for claim substantiation validation for the advertising of cosmetic and personal care products. Keywords : Personal Reported Outcomes, CROM, FDA, FTC, Cosmetic productsPeer reviewe

Drugs associated with prescribing errors in older patients in two English general practices

Medication errors have the potential to cause patient morbidityand mortality, and increase pressure on healthcare. Studies haveindicated that older patients may be more susceptible tosignificant risks of harm from prescribing errors1,2, though thereis a dearth of research in this patient group.Peer reviewe

An investigation into the effectiveness of antimicrobial stewardship during a pandemic- COVID-19 in acute care setting

Review question 1. What strategies have been employed for effective antibiotic utilization/antimicrobial stewardship during pandemics? 2. What challenges have arisen in the use of antibiotics due to pandemics? 3. What antibacterial stewardship strategies have been employed in the acute care setting during the COVID-19 pandemic? 4. What antibacterial stewardship strategies can be adapted for use in acute care settings during pandemics? Searches [1 change] Firstly, rapid reviews in the PROSPERO were conducted for previously accepted systematic reviews, using different search terms that were used to carry out database searches for published articles from 2007 to March 2021. Then, the first search was completed on MEDLINE, using a comprehensive list of search terms, and this search was then amended or modified in the subsequent databases depending on the subject headings and keywords and their synonyms identified in the databases with more relevant and related keywords. A combination of keywords (searching the title and abstract) and index terms, as well as their synonyms where applicable, were used depending on the database. Spelling variations for different search terms were also employed. then search continued using the title field of the following databases: AMED (Allied and Complementary data Medicine); EMBASE; Embase classic; Global Health; HMIC (Health Management Information Consortium); International Pharmacutical Abstracts; Health and Psychosocial Instruments; PsycEXTRA; PsycINFO; Maternity & Infant Care Database (MIDIRS); PubMed; Scopus; Web of Science; C​I​N​A​H​L

Evaluation of a clinical pharmacy programme Japan-UK collaboration

The development of Clinical Pharmacy in the United Kingdom (UK) has been established since the 1980's. The concept of pharmaceutical care has developed over the past 30 years and more recently the pharmacists role in medicines optimisation and safety was endorsed by the UK government 2010.The University of Hertfordshire (UH) established a memorandum of understanding with Meiji Pharmaceutical University (MPU) in 2009. Staff exchange and the delivery of clinical pharmacy and patient safety seminars was established in 2009. A unique six week student clinical pharmacy programme was launched in 2010.Tutors at MPU identified students who had completed the 4/5th year of the pharmacy programme and had the appropriate level of language skills to benefit from the programme. MPU identified students were selected through interview with UH tutors. The goal of the clinical programme was to enable students from MPU experience UK educational methods of learning, interaction with UK students and develop a portfolio of clinical practice. The students also had first hand observational experience of a wide range of UK clinical practice. The aim was to evaluate the achievements of this programme.Peer reviewe

Antibiotic Prescribing: A Retrospective Study from One English National Health Service (NHS) Foundation Trusts Before And During The COVID-19 Pandemic.

This research by Abdelsalam Elshenawy Rasha., investigates antibiotic prescribing practices before and during the COVID-19 pandemic at an English NHS Trust. It focuses on understanding the implications of Antimicrobial Resistance (AMR) in the context of a global rise in multi-drug-resistant infections. Utilising a cross-sectional retrospective study, it analyses data from electronic medical records of patients with Respiratory Tract Infections, employing the WHO's AWaRe classification. The study reveals significant changes in antibiotic prescribing patterns during the pandemic, highlighting the urgent need for continued antimicrobial stewardship to ensure responsible antibiotic use and combat AMR.Peer reviewe