Antimicrobial stewardship in wound care

a position paper from the British Society for Antimicrobial Chemotherapy and European Wound Management Association

Benjamin A. Lipsky (Lead / Corresponding author), Matthew Dryden, Finn Gottrup, Dilip Nathwani, Ronald Andrew Seaton, Jan Stryja

    Research output: Contribution to journalReview article

    32 Citations (Scopus)

    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.

    Original languageEnglish
    Pages (from-to)3026-3035
    Number of pages10
    JournalJournal of Antimicrobial Chemotherapy
    Volume71
    Issue number11
    Early online date25 Jul 2016
    DOIs
    Publication statusPublished - Nov 2016

    Fingerprint

    Wounds and Injuries
    Anti-Bacterial Agents
    Therapeutics
    Telecommunications
    Microbial Drug Resistance
    Microbiology
    Administrative Personnel
    Communicable Diseases
    Patient Care
    Bacteria
    Infection

    Keywords

    • antibiotics
    • antibiotic resistance
    • bacterial
    • wound infection
    • infetion
    • antibiotic therapy
    • antimicrobials
    • wound care
    • prescribing behavior
    • antimicrobial stewardship program

    Cite this

    Lipsky, Benjamin A. ; Dryden, Matthew ; Gottrup, Finn ; Nathwani, Dilip ; Seaton, Ronald Andrew ; Stryja, Jan. / Antimicrobial stewardship in wound care : a position paper from the British Society for Antimicrobial Chemotherapy and European Wound Management Association. In: Journal of Antimicrobial Chemotherapy. 2016 ; Vol. 71, No. 11. pp. 3026-3035.
    @article{fdb2669bb0f74c09bd9da4927e0f7b40,
    title = "Antimicrobial stewardship in wound care: a position paper from the British Society for Antimicrobial Chemotherapy and European Wound Management Association",
    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.",
    keywords = "antibiotics, antibiotic resistance, bacterial, wound infection, infetion, antibiotic therapy, antimicrobials, wound care, prescribing behavior, antimicrobial stewardship program",
    author = "Lipsky, {Benjamin A.} and Matthew Dryden and Finn Gottrup and Dilip Nathwani and Seaton, {Ronald Andrew} and Jan Stryja",
    note = "This position paper was supported by internal funding. Klaus Boberg Pedersen and Niels Fib{\ae}k Bertel are employees of the European Wound Management Association Secretariat and provided administrative assistance to the project, including overall project management, meeting preparation, overseeing a literature search, organizing scientific references and submission of the manuscript to the journal.",
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    Antimicrobial stewardship in wound care : a position paper from the British Society for Antimicrobial Chemotherapy and European Wound Management Association. / Lipsky, Benjamin A. (Lead / Corresponding author); Dryden, Matthew; Gottrup, Finn; Nathwani, Dilip; Seaton, Ronald Andrew; Stryja, Jan.

    In: Journal of Antimicrobial Chemotherapy, Vol. 71, No. 11, 11.2016, p. 3026-3035.

    Research output: Contribution to journalReview article

    TY - JOUR

    T1 - Antimicrobial stewardship in wound care

    T2 - a position paper from the British Society for Antimicrobial Chemotherapy and European Wound Management Association

    AU - Lipsky, Benjamin A.

    AU - Dryden, Matthew

    AU - Gottrup, Finn

    AU - Nathwani, Dilip

    AU - Seaton, Ronald Andrew

    AU - Stryja, Jan

    N1 - This position paper was supported by internal funding. Klaus Boberg Pedersen and Niels Fibæk Bertel are employees of the European Wound Management Association Secretariat and provided administrative assistance to the project, including overall project management, meeting preparation, overseeing a literature search, organizing scientific references and submission of the manuscript to the journal.

    PY - 2016/11

    Y1 - 2016/11

    N2 - 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.

    AB - 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.

    KW - antibiotics

    KW - antibiotic resistance

    KW - bacterial

    KW - wound infection

    KW - infetion

    KW - antibiotic therapy

    KW - antimicrobials

    KW - wound care

    KW - prescribing behavior

    KW - antimicrobial stewardship program

    UR - http://jac.oxfordjournals.org/

    U2 - 10.1093/jac/dkw287

    DO - 10.1093/jac/dkw287

    M3 - Review article

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    JO - Journal of Antimicrobial Chemotherapy

    JF - Journal of Antimicrobial Chemotherapy

    SN - 0305-7453

    IS - 11

    ER -