Many consider the UK the most vocal and “advanced” Nation on the Planet when it comes to its National response and clearly expressed responsibilities as concerns antimicrobial Stewardship (AMS) and the judicious use of antibiotics – and turning Stewardship into reality. The UK’s position here has arisen from the very hard hitting O’Neill report, stating that deaths from AMR are likely to exceed those from cancer and other diseases by 2050, and our previous Chief Medical Officer’s endorsement and active commitment to the Stewardship Cause, not only in the UK but also in Europe, where she spearheaded multi-Nation action. Accordingly, such pressure has led to much good and continuing work by the UN Interagency Coordination Group (IACG) on Antimicrobial Resistance. But what does this mean for those at the Clinical coal face? And how can National if not Global aspirations, be turned into action that makes a difference? “Stewardship” per se cannot neatly be packaged up and legislated with Standard Operating Procedures, as it is fundamentally an abstract concept, where no size fits All. More specifically – this is about changing antibiotic prescribers’ habits, by inviting them to do better for their patients, where coercion or restriction is rarely possible and usually not appropriate. But how is this achieved, and what is the “incentive” for individuals who might (over) prescribe because they might have always done so, and the downsides of what they do are usually not obvious to them? The Societal Burden of what they do is not clear to them as “their problem”. This talk will bring some focus on the current UK situation and illustrate it through our current UK National Institutes of Health Research (NIHR) INHALE research project, designed to ask whether the rapid and accurate molecular diagnosis of both the Bacteria and their antibiotic sensitivity in less than an hour in the context of a critically ill Intensive Care environment, makes a difference. Some insights into what we have learnt as concerns this ongoing work’s relevance to our mandatory AMS journey will be presented.
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