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(47% vs. 89%), respectively. Combined POCT resulted in the best

sensitivity (98%) and specificity (81%). Nearly one in ten patients

received an antimicrobial to which the organism was not fully


Discussion and/or Conclusion(s):

One rapid, cost-effective POCT was

too inaccurate to be used alone by healthcare workers, impeding

antibiotic stewardship in a high ESBL setting. Appropriate prescribing

is improved with concurrent use and concordant results of urine

dipstick and microscopy.

ID: 4469

Development of an antimicrobial stewardship peer review system

for the East of England Pharmacy Infection Network

Emma Cramp.

Hinchingbrooke NHS Hospital


There have been a number of UK national guidelines to

support Antimicrobial Stewardship pulished recently. The diversity of

these resources, given that they have been produced by different

expert groups, and at different time points, makes it challenging for

teams to establish which guidance to follow. In response to this,

the recommendations from these national resources were reviewed

and collated into one complete AMS tool to provide clarity to enable

the recommendations to be followed. The intention is to use the tool

to enable a peer reviewof AMS activities in acute NHS Trusts in the East

of England region.


To develop a tool to facilitate the peer review of

antimicrobial stewardship activities in acute hospitals in the EoE.


Guidance from national documents relating to antimicro-

bial stewardship were reviewed and used to formulate a draft tool. This

tool was circulated to the EoE regional antimicrobial pharmacist


network for comment. The draft tool was used as part of a pilot peer

review visit at two acute hospitals.


Feedback received from the participants of the pilot peer

review informed the publication of the final peer review tool. The tool

was able to identify gaps in antimicrobial stewardship practice at each


Discussion and/or Conclusion(s):

The next stage of implementation

will be to adopt a peer review process using the tool across the East of

England region. We hope that this system will provide a unique and

systematic review of AMS activities and lead to recommendations for

improvement and sharing of best practice throughout the region.

ID: 4515

Surgeons when it comes to managing cutaneous abscesses know

about your ISAs (Incisions, Swabs and Antibiotic stewardship)

Richard Pilkington


, Jonathan Moore


, Luke Banbury





Education North East,


Dept of Microbiology, Gateshead NHS Trust,


Foundation Dr, Queen Elizabeth Hospital Gateshead


Cutaneous abscesses are commonly encountered in

clinical practice. Conventional wisdom dictates that incision and

drainage (I+D) is the treatment of choice. The role of antibiotics

and microbiological sampling at the time of drainage is less well

established. Our hospital has a successful pathway to identify and

manage patients requiring surgical intervention.


We evaluate what microbiology samples are sent

and how useful these results are, as well as considering what therapy

patients on this pathway receive with the intention of improving the

pathway and antibiotic stewardship.


109 cases of I + D were reviewed. For each case, we

identified if swabs were taken and if antibiotics were prescribed and

then analysed the culture results.


Of 109 I + D carried out (66 perianal, 24 abdominal, 16

axilla/breast and 3 lower limb), swabs were taken in 100 cases. 37% of

samples were culture negative. As expected, Gram negative and

anaerobic florawere most frequently isolated form perianal swabs and

Gram positive flora from other sites. Varied antibiotic practice was


Discussion and/or Conclusion(s):

The mainstay of treatment for

cutaneous abscess is surgical I + D. Our hospital pathway works well in

identifying patients requiring I + D and conducting this surgery.

However, presently samples are sent in the majority of cases and

antibiotic practice variable. We propose that our pathway is developed

to provide a selective framework for cases where microbiology

work up is likely to be most beneficial and to improve antibiotic

stewardship both before and after I + D to make best use of precious


ID: 4520

Implementing an antimicrobial stewardship training and

mentorship programme and encouraging key nurse led



Frances Kerr, Paula Smith, David Watson, Steve McCormick.




Antimicrobial resistance is a recognised issue. Nurses

with more patient contact than other health professionals are in a key

position to influence safe, effective prescribing and administration of



To implement a ward based antimicrobial

stewardship programme for nurses highlighting key opportunities

for intervention, encouraging

antibiotic conversations

and acting as

effective safety nets.


Ward buzz session ran over 6 weeks fromMay

June 2015.

Materials and training were tested separately. Training was focused

on antibiotic policies and key opportunities to initiate antibiotic

conversations. Pre/post training questionnaires were used to assess

the impact of training and nurse confidence levels. Paired T-test was

used to assess impact.


13 nurses were trained and 12 pre/post questionnaires were

returned. 83% (n = 10) of nurses said it changed their practise. 100%

would recommend training to colleagues.

A statistically significant increase in confidence in initiating conver-

sations (p = 0.046) was observed. Pre-training 75% of nurses had


conversations per week, post-training 67% had

3 conversations.

A statistically significant increase in confidence assessing vancomycin

levels (P = 0.005) was demonstrated. No significant change in con-

fidence with gentamicin was seen (p = 0.054).

Overall nurses were more confident at querying antibiotic prescribing,

a clear safety benefit for patients.

Discussion and/or Conclusion(s):

Although the sample size was

small, nurses showed increased awareness of antibiotic policies and

increased confidence in using them, resulting in increased nurse

initiated antibiotic conversations. Nurse feedback was very positive,

they felt strongly that this training would benefit their colleagues.

An action plan is being formulated to ensure rollout to all nursing staff.

ID: 4545

European Antibiotic Awareness Day (EAAD) activities

across Scotland: Views and experiences of the

community pharmacy team

Antonella Tonna


, Jacqui Sneddon


, Anita Weidmann


, Derek Stewart




Robert Gordon University School of Pharmacy and Life Sciences,



Medicines Consortium,


Robert Gordon University


EAAD is a European wide public health initiative

encouarging responsible use of antibiotics amongst the general

public. Community Pharmacy teams across Scotland are supported

to partake in EAAD through activities coordinated by the Scottish

Antimicrobial Prescribing Group (SAPG). In 2014, this included using

a community pharmacy version of a self help guide published by

the Royal College of General Practitioners and distributed to all

community pharmacies.


To explore the views and experiences of

community pharmacy teams across Scotland of using this self help


Abstracts of FIS/HIS 2016

Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24