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Point prevalence surveys (PPS) can demonstrate

strengths and areas for improvement within antimicrobial steward-

ship (ASP) programmes but are inherently labour-intensive. Imperial

College Healthcare NHS Trust has undertaken PPS since 2002. In

2015/16 electronic prescribing (e-prescribing) was introduced, pro-

viding an opportunity to reassess delivery of PPS.


We aimed to evaluate how the introduction of

e-prescribing affected PPS in terms of ease of data collection and

human resources.


All inpatients scheduled to receive anti-infectives on the

day of data collection were included in the February 2016 study.

Antimicrobial pharmacists noted time taken to audit each clinical

area and any significant ASP interventions made before analysis of



Of 84 wards (1267 patients) reviewed, 36 retained paper-

based systems, 4 utilised specialist intensive care prescribing pro-

grammes and 44 had moved to e-prescribing. Whilst overall

antimicrobial prescribing indicators remained similar to previous

years, the average PPS time taken per ward (hh:mm) was reduced

from 1:07 for paper-based areas to 00:24 for e-prescribing locations

(00:32 in intensive care areas). On paper-based wards, interventions

identified were around dose optimisationwhereas those identified via

electronic systems mainly concerned course duration.

Discussion and/or Conclusion(s):

Electronic record and prescription

systems have dramatically reduced the time taken to undertake

PPS. Even greater efficiency improvements are anticipated in future,

following Trust-wide adoption of electronic prescribing.

Interventions identified on paper systems involved dose optimisation

whereas these were not seen within e-prescribing areas. It is hypo-

thesized that in-built e-prescribing user support influenced the

interventions identified.

ID: 5016

Progress towards achieving antimicrobial prescribing standards in

medical wards at Aberdeen Royal Infirmary

Fiona McDonald, Gillian Macartney, Rashmi Subbarao-Sharma.




In NHS Grampian the Antimicrobial Management Team

co-ordinate annual antibiotic point prevalence audits across all acute

hospitals, as recommended by the Scottish Antimicrobial Prescribing



To monitor compliance with local antimicrobial

guidelines, against agreed audit standards.


Data was collected by pharmacists using a standard

data collection form over 2 days in November/December each year.

The Antibiotic Pharmacists, in liaison with Medical Microbiologists,

assessed whether antibiotic prescribing was


. Compliance

against audit standards was calculated. A report summarising

the results for all medical wards was disseminated to clinical staff

each year and individualised reports sent to wards with the lowest

rates of compliance with the audit standards.


Percentage of indications documented inmedical notes/drug chart

improved from 88% in 2010 to 98% in 2015. (Audit Standard (AS)


Percentage of antibiotic prescriptions with duration/stop/review

date documented in medical notes/drug chart improved from 30%

in 2010 to 65% in 2015. (AS


Percentage of indications where review of antibiotics was

documented within last 48 hours in medical notes improved

from 80% in 2013 to 94% in 2015. (AS

80%) (Datawas not collected

in 2010.)

Percentage of indications where prescribing was appropriate

improved from 87% in 2010 to 92% in 2015. (AS


Percentage of doses administered improved from 93% in 2014 to

96% in 2015. (Data not collected in 2010 or 2013.) (AS


Discussion and/or Conclusion(s):

Between 2010 and 2015 there have

been improvements across all of the audit standards, with a significant

improvement for documentation of duration/stop/review dates and

documented reviews.

ID: 5022

Antimicrobial Stewardship (AMS) activities in English Community

Health Services (CHS) Trusts

Diane Ashiru-Oredope


, Sejal Hansraj


, Mary Akpan


, Nada Atef Shebl



Raheelah Ahmad


, Susan Hopkins




Public Health England,



of Hertfordshire,


Imperial College London


The implementation of the national toolkits TARGETand

SSTF, led by PHE is listed as one of strategic actions for implementing

the UK 5 year Antimicrobial Resistance (AMR) Strategy. The imple-

mentation of these toolkits has previously been assessed in CCGs and

Acute Trusts.


To gain an understanding of current AMS

activities in CHS Trusts.


In February 2016, an online survey was distributed to the

26 English CHS Trusts. This was a voluntary service evaluation by

healthcare professionals; ethics approval was not required.


77% of CHS Trusts responded to the survey; of these, 25% (5%

in CCGs and 94% in Acute Trusts) had a substantive pharmacy post

focussed on AMS. 50% of responding CHS Trusts had an AMS

committee (18% in CCGs; 94% in Acute Trusts).

85% of responding CHS Trusts had an antimicrobial formulary (99% in

CCGs; 93% in Acute Trusts), while 55% had empirical antibiotic

guidelines in place (73% in CCGs; 83% in Acute Trusts).

Other key findings include that 70% of responding CHS Trusts had an

antimicrobial policy in place (99% in CCGs; 93% in Acute Trusts), while

90% indicated that they were aware of TARGET, and of these, 11 had

formally reviewed it. With SSTF, 75% of CHS Trusts reported being

aware of SSTF and of these, 10 had formally reviewed it.

Discussion and/or Conclusion(s):

Study results demonstrate that

AMS guidance has been focused on initiatives to improve its imple-

mentation in primary and secondary care. Further work is required to

promote AMS delivery in CHS Trusts.

ID: 5031

Protected antibiotic use at the Central Manchester NHS Foundation

Trust: findings from a prospective antibiotic stewardship


Giorgio Calisti, Rob Shorten, Louise Sweeney, Mihaela Petric,

Catherine Child, Benjamin Farrington, Caroline Templeton,

Kelly Alexander, Ahmed Qamruddin.

Central Manchester University

Hospitals NHS Foundation Trust


As part of our Antimicrobial Stewardship strategy, we

reviewed daily all pharmacy requests for protected antibiotics (i.e.,

meropenem, ertapenem and linezolid) in our Trust. We reviewed the

case notes, drug chart and laboratory information system to evaluate

the rationale for starting the protected antibiotic and whether the

prescription was appropriate or not.

The appropriateness of the prescription was discussed in a daily

clinical meeting attended by Medical Microbiology Doctors and

Antibiotic Pharmacists. The possible outcomes of the multi-disciplin-

ary discussion were:

Stop the protected antibiotic without starting a new antibiotic in


Switch the protected antibiotic to a non-protected alternative

Continue the protected antibiotic.


The most commonly used protected antibiotic was merope-

nem, followed by linezolid and ertapenem. The protected antibiotic

was started as an escalation in most patients and a discussion with

Microbiology was documented in half of the cases.

The most common indication for starting the protected antibiotic

was the recent isolation of a MDR organism not covered by the

Abstracts of FIS/HIS 2016

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