Scottish Management of Antimicrobial Resistance Action Plan 2014-18 (ScotMARAP2)

Action Plan: Prescribers' Individual Responsibilities

Patient safety and quality of care is the personal responsibility of each prescriber. In the context of ScotMARAP 2 all prescribers must ensure they have adequate knowledge of management of infection and appropriate antimicrobial use.

Key objectives for prescribers are:

• Ensure that all use of antimicrobials is rational and appropriate. (Area 2)
• Document in the medical notes the indication for prescribing an antimicrobial, supporting rationale for the decision to prescribe and the intended duration of antimicrobial therapy. (Area 2)
• Follow local antimicrobial guideline to ensure appropriate choice, route, dose and duration. (Area 2)
• Use narrowest spectrum agent possible. (Area 2)
• Comply with local policies to restrict the use of antimicrobials with a high risk of CDI and 'Alert' antimicrobials. (Area 2)
• Seek specialist advice from Microbiology, Infectious Diseases or Pharmacy (as appropriate) if required and document the advice received in the medical notes. (Area 2)
• Ensure empirical antimicrobial prescriptions are reviewed within 48-72 hours and therapy is de-escalated where appropriate. (Area 2)
• Ensure appropriate therapeutic drug monitoring of antimicrobials following local policy. (Area 2)
• Identify and report adverse event or harm from antibiotics through local risk management system and participate in significant adverse events analysis where appropriate.
• Participate and show evidence of engagement with opportunities for education and training on antimicrobials and management of infection. (Area 3)
• Engage with data collection and feedback activities for national and local prescribing indicators. (Areas 2 & 3)
• Contribute to individual and organisational actions necessary to improve antimicrobial use as highlighted by national and local surveillance and prescribing indicator data. (Area 2)