Lipsky BA, Dryden M, Gottrup F, Nathwani D, Seaton RA, Stryja J, et al.
The Journal of antimicrobial chemotherapy. Date of publication 2016 Nov 1;volume 71(11):3026-3035.
1. J Antimicrob Chemother. 2016 Nov;71(11):3026-3035. Epub 2016 Jul 25.
Antimicrobial stewardship in wound care: a Position Paper from the British
Society for Antimicrobial Chemotherapy and European Wound Management Association.
Lipsky BA(1)(2), Dryden M(3), Gottrup F(4), Nathwani D(5), Seaton RA(6), Stryja
J(7).
Author information:
(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.
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.
© The Author 2016. Published by Oxford University Press on behalf of the British
Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions,
please e-mail: journals.permissions@oup.com.
DOI: 10.1093/jac/dkw287
PMID: 27494918 [Indexed for MEDLINE]
