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strongly agreed that antibiotics are overused in the UK and that

resistance is a problem in the UK, but were neutral with regards to

resistance being a problem in their hospital. Only 9% felt confident

in prescribing antibiotics. Specific areas of weakness included

de-escalation of antibiotics, dosing, and transitioning from IV to oral

antibiotics, as well as appropriate prescribing in the context of known


Discussion and/or Conclusion(s):

Our findings suggest that students

perceive resistance as a national/international problem rather than a

local problem, and that future prescribers lack knowledge and

understanding of antimicrobial stewardship required to counter the

spread of resistance. Further studies are required to clarify the

generalisabilty of these findings and guide future medical school


ID: 4754

An audit to assess the influence of procalcitonin on patient

management after providing 24/7 cover of procalcitonin testing

Chandanie Mendis Ramasundara, Kordo Saeed, Bruce Wake.

Hampshire Hospitals NHS Foundation Trust


Bacterial sepsis is a major course of morbidity and

mortality. Procalcitonin (PCT) ia a useful guide for the clinicians to

take correct decisions on antibiotic prescribing to improve patient

outcome by reducing emergence of resistence and health care costs.


To assess the indications and how early provision

of PCT results influence patients

management and outcome.


Details of 130 PCT episodes were collected from 104

patients admitted to Basingstoke and North Hampshire Hospital

(BNHH). Patients were followed prospectively for 7 days to assess the



The majority of patients were between 40

90 years (95%).

62% of them were males.

The main indications for PCT were to support the diagnosis or

exclusion of bacterial infection [n-60, (46%)] and to assess the response

to treatment [n-33, (25%)]. Only 8% of PCT were done for earlier

stopping of antibiotics when a course already started.

In 37% of episodes, the clinicians were continued the same antibiotics.

In 27% of episodes antibiotics were withheld and in 9% were stopped.

De-escalated only in 3 episodes.

Two patients who have not started antibiotics died and 7 were not

improved. Patients died, not at the result of infection. All de-escalated

patients were improved. 75% of PCT episodes had an impact on


management according to the BNHH Micro guide PCT results

interpretation criteria.

Discussion and/or Conclusion(s):

Higher percentage of PCT episodes

had an impact on patients

management. Majority of patients were

improved within 7 days. The early and regular provision of PCT results

help clinicians to take appropriate decisions regarding antibiotic


ID: 4766

Audit of antimicrobial prophylaxis in adult patients undergoing

neurosurgical and spinal surgeries at Newcastle Upon Tyne

Hospitals NHS Foundation Trust

Harish Reddy


, Manjusha Narayanan




Freeman Hospital, Newcastle

Upon Tyne Hospitals NHS Foundation Trust,


Newcastle Upon Tyne

Hospitals NHS Foundation Trust


Wound infection of incised skin or soft tissue during operations

is common, but incidence can be reduced by the use of antibiotics

for surgical prophylaxis. But if used inappropriately, it can be


Carrying out an audit in this area will provide an indication of the

quality of antibiotic prescribing in practice and would highlight

areas for potential improvement

This was a new audit following introduction of protocol for

neurosurgical and spinal surgeries


To study quality of adherence to hospital protocol for antimicrobial

prophylaxis and explore reasons for non-adherence

Promote good record keeping and awareness of good prescribing


Objective evaluation of antimicrobial prescribing quality, suitable

for on-going prescriber feedback


The standard compared in this audit was Newcastle Upon Tyne

neurosurgical and spinal surgery prophylaxis protocol, which have

been developed based on current best evidence

Audit was conducted over 2-week period and data was obtained

from theatre list

Audit data was obtained from case note review, e-records and

Pathology software system


Choice of antimicrobial prophylaxis was as per the guidelines in

only 60%

Only 7% of patients received antibiotics at the right time

Small proportion (5%) of patients received inappropriate add-

itional doses of antibiotics

Discussion and/or Conclusion(s):

Inappropriate administration of antibiotics increases prevalence of

antibiotic-resistant bacteria, and predisposes patient to infection

with organisms like

C. difficile

. It is hoped that findings of this audit

will emphasize importance of adherence to trust antimicrobial

prophylaxis protocol

Feedback and further audits might encourage surgeons to

undertake their own data collection on a rolling programme

basis, which helps evaluate improvement in prophylactic anti-

biotics prescription

Emphasise the importance of adherence to timing of antibiotic


ID: 4771

Evaluation of the role of the Antimicrobial Management Team

Nurse in achieving improvements in antimicrobial stewardship

Alison Cockburn.

NHS Lothian


Within the Antimicrobial Management Team (AMT) in

NHS Lothian a nurse was appointed to perform clinical auditing of

antimicrobial use and education of nurses and prescribers. New

antimicrobial prescribing guidelines were implemented within the

Board in April 2015 to reduce broad spectrum antibiotic usage and

reduce Clostridium difficile infection (CDI). During the routine audit

cycle, issues with inaccuracies with gentamicin prescribing procedures

was identified and an audit undertaken by the AMT Nurses to

investigate this situation.


The aim of this study was to evaluate the role of

the AMT Nurse in achieving improved antimicrobial stewardship

related to gentamicin administration and prescribing.


Antibiotic prescribing on 18 medical and surgical wards

was audited to assess adherence to the antibiotic prescribing guide-

lines and procedures for gentamicin prescribing. Education was

subsequently provided for nursing staff on gentamicin administration

and prescribing. Additionally, a gentamicin dosing wheel was created

and implemented to assist nurses in calculating blood sample timings.

A staff survey and further audit was then performed.


The audit showed that 90% of prescriptions contained errors

involving documentation, sampling or administration of gentamicin.

Following implementation of the education programme the error rate

dropped to 13%. Improvements in nurses

level of knowledge regarding

gentamicin prescribing and administration were also achieved.

Discussion and/or Conclusion(s):

This study showed that the

AMT nurse has an effective role within the AMT assisting the

implementation of policies and guidelines, monitoring practices,

enabling knowledge sharing and providing education on antimicrobial


Abstracts of FIS/HIS 2016

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