Benjamin A Lipsky1,2, Matthew Dryden3, Finn Gottrup4, Dilip Nathwani5, Ronald Andrew Seaton6, Jan Stryja7. 1. Division of Medical Sciences, Green Templeton College, University of Oxford, Oxford OX2 6HG, UK dblipsky@hotmail.com. 2. University of Washington, Seattle, WA 98195, USA. 3. Department of Microbiology and Infection, Hampshire Hospitals Foundation NHS Trust, Winchester SO22 5DG, Hampshire, UK. 4. Copenhagen Wound Healing Center, Bispebjerg University Hospital, DK-2400 Copenhagen, Denmark. 5. Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK. 6. Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK. 7. Department of Science and Research, Educational and Research Institute AGEL, 796 04 Prostejov, Czech Republic.
Abstract
BACKGROUND: With the growing global problem of antibiotic resistance it is crucial that clinicians use antibiotics wisely, which largely means following the principles of antimicrobial stewardship (AMS). Treatment of various types of wounds is one of the more common reasons for prescribing antibiotics. OBJECTIVES: This guidance document is aimed at providing clinicians an understanding of: the basic principles of why AMS is important in caring for patients with infected wounds; who should be involved in AMS; and how to conduct AMS for patients with infected wounds. METHODS: We assembled a group of experts in infectious diseases/clinical microbiology (from the British Society for Antimicrobial Chemotherapy) and wound management (from the European Wound Management Association) who, after thoroughly reviewing the available literature and holding teleconferences, jointly produced this guidance document. RESULTS: All open wounds will be colonized with bacteria, but antibiotic therapy is only required for those that are clinically infected. Therapy is usually empirical to start, but definitive therapy should be based on results of appropriately collected specimens for culture. When prescribed, it should be as narrowly focused, and administered for the shortest duration, as possible. AMS teams should be interdisciplinary, especially including specialists in infection and pharmacy, with input from administrative personnel, the treating clinicians and their patients. CONCLUSIONS: Available evidence is limited, but suggests that applying principles of AMS to the care of patients with wounds should help to reduce the unnecessary use of systemic or topical antibiotic therapy and ensure the safest and most clinically effective therapy for infected wounds.
BACKGROUND: With the growing global problem of antibiotic resistance it is crucial that clinicians use antibiotics wisely, which largely means following the principles of antimicrobial stewardship (AMS). Treatment of various types of wounds is one of the more common reasons for prescribing antibiotics. OBJECTIVES: This guidance document is aimed at providing clinicians an understanding of: the basic principles of why AMS is important in caring for patients with infected wounds; who should be involved in AMS; and how to conduct AMS for patients with infected wounds. METHODS: We assembled a group of experts in infectious diseases/clinical microbiology (from the British Society for Antimicrobial Chemotherapy) and wound management (from the European Wound Management Association) who, after thoroughly reviewing the available literature and holding teleconferences, jointly produced this guidance document. RESULTS: All open wounds will be colonized with bacteria, but antibiotic therapy is only required for those that are clinically infected. Therapy is usually empirical to start, but definitive therapy should be based on results of appropriately collected specimens for culture. When prescribed, it should be as narrowly focused, and administered for the shortest duration, as possible. AMS teams should be interdisciplinary, especially including specialists in infection and pharmacy, with input from administrative personnel, the treating clinicians and their patients. CONCLUSIONS: Available evidence is limited, but suggests that applying principles of AMS to the care of patients with wounds should help to reduce the unnecessary use of systemic or topical antibiotic therapy and ensure the safest and most clinically effective therapy for infected wounds.
Authors: Nyasha Allen; Lisa J White; Jessica E Boles; George T Williams; Dominique F Chu; Rebecca J Ellaby; Helena J Shepherd; Kendrick K L Ng; Laura R Blackholly; Ben Wilson; Daniel P Mulvihill; Jennifer R Hiscock Journal: ChemMedChem Date: 2020-10-16 Impact factor: 3.466
Authors: Ana Oliveira; Henrique G Ribeiro; Ana C Silva; Maria D Silva; Jessica C Sousa; Célia F Rodrigues; Luís D R Melo; Ana F Henriques; Sanna Sillankorva Journal: Front Microbiol Date: 2017-12-08 Impact factor: 5.640