With the fourth annual European Antibiotic Awareness Day being held this Friday, 18 November 2011, a series of events, including a public information campaign, are planned around this date to highlight the importance of rational antibiotic use in the prevention and control of antibiotic resistance.

Antibiotic resistance is a major threat to patient safety. Infections caused by antibiotic resistant bacteria result in significantly increased patient morbidity and mortality. Infections caused by many types of antibiotic resistant bacteria are increasing in Ireland, and this is frequently linked to inappropriate use of antibiotics. Thus it is vital that we apply a rational approach to antibiotic prescribing that maximises the likelihood of successfully treating infections, while minimising the risk of selecting out antibiotic resistance. 

Please click here to read the complete Guidelines on Prescribing.  

For example, when treating infections, the following basic principles should be applied:

At initiation of empiric antibiotic therapy:

·         Document clinical rationale for antibiotic initiation

·         Ensure appropriate specimens have been sent to diagnostic microbiology laboratory

·         Review any previous microbiology results from the patient to guide empiric therapy

·         Ensure antibiotic prescribed is in accordance with local policy and patient risk group

·         Consider removal of foreign body/drainage of pus/surgical intervention

On continuation of antibiotic therapy

·         Use laboratory results to narrow the spectrum of antibiotic cover, where possible

·         Consider changing from  intravenous to oral antibiotics, or stopping antibiotics (based on review of clinical picture and laboratory results) on a daily basis

·         Where necessary, ensure antibiotic drug levels are monitored as required by local policy

For peri-operative antibiotic prophylaxis, the following principles should be applied:

·         Ensure the agent selected matches local guidelines for that operation for that patient

·         Ensure the first dose is given between 30 minutes –1 hour pre incision

·         Stop antibiotics by 24 h after the pre-operative dose (for the majority of surgical procedures a single dose of appropriately timed antibiotics is sufficient)

By applying these principles and engaging with local infection specialists (microbiologists, infectious disease physicians, antimicrobial pharmacists), infection-related morbidity and mortality can be reduced, adverse drug reactions avoided and antibiotic resistance minimised.

Antibiotics are a precious medical resource. As prescribers, it is up to us to ensure they are used effectively and their efficacy preserved for future generations.