In a busy London tertiary hospital I start my day by replying to any urgent emails relating to antimicrobials. At the moment I am coordinating the quarterly antimicrobial prescribing audits with the pharmacy department ensuring that the data is collected within the two week period, before analysing the data to produce a report on how different medical areas are complying with set measured criteria.
In a busy London tertiary hospital I start my day by replying to any urgent emails relating to antimicrobials. At the moment I am coordinating the quarterly antimicrobial prescribing audits with the pharmacy department ensuring that the data is collected within the two week period, before analysing the data to produce a report on how different medical areas are complying with set measured criteria.
There are daily ward rounds which I attend with the consultant microbiologist. Today is the Adult Intensive Care Unit (AICU) ward round, so prior to that I check the patient’s electronic drug chart for antimicrobials prescribed with their other medications, to identify any drug interactions, monitor their biochemistry results for signs of improvement in their inflammatory markers, but also look for signs of toxicity and check that antibiotic drug levels are within range. The AICU ward round is also attended by the AICU pharmacist, doctors and consultant microbiologist. We discuss the patient’s daily progress with new findings, new microbiology results and plans for the next 24–48 hours. This is where I suggest changes to antibiotic doses or formulations and highlight drug interactions, taking into account any organ dysfunction to optimise the patient’s antimicrobial therapy and minimise toxicity.
During the afternoon I have a meeting with the consultant microbiologist to discuss the progress of our antimicrobial stewardship programme. At the moment we are updating our Antimicrobial Prescribing Guide to ensure that they reflect current practices and evidence. Back at my desk I continue to create reports for our Antimicrobial Strategy Group such as expenditure, antimicrobial usage, antimicrobial resistance trends and medication incidents relating from antimicrobials. I then prepare for the antifungal stewardship rounds for the following day with our infectious diseases mycologist, where we review respiratory patients on antifungals to ensure appropriate treatment and provide recommendations.
