Healthcare leaders concerns over the government’s latest sepsis treatment initiative have been revealed.
Leading public health speakers criticised the scheme, which suggests increasing use of antibiotics to treat sepsis at the same time as the government is attempting to reduce the amount of antibiotics prescribed.
A patient safety alert released by NHS England earlier this month said that “fast administration of intravenous antibiotics” is key to reducing the numbers of people who die from the condition in the UK.
The Department of Health has published a five-year antimicrobial resistance plan for the UK, which calls for professional education, public engagement and steps to improve antibiotic prescribing.
Many studies have shown a link between frequent, long courses of antibiotics and antibiotic resistance.
Speaking at the Public Health England annual conference in Coventry, Alison Holmes, a professor of infectious diseases at Imperial College London said that tackling antimicrobial resistance is essential, but that the sepsis patient safety alert highlighted a lack of joined-up thinking.
“It’s critical - we’ve missed such an opportunity with the sepsis initiative. The safety alert that came out did not reinforce the programme of reducing antibiotic use,” she said.
“We really need to look at a more joined up approach and look at the whole patient journey when we’re looking at antimicrobial resistance. It’s not enough to be looking at it in primary or acute care, we need to have ways of looking at the whole patient pathway. We’ve been talking about countries working together globally [to improve antimicrobial resistance], but at the same time we’re not actually working across our own health economies.”
More than 70% of sepsis cases occur in the community. Unless treated quickly, sepsis can progress through severe sepsis, multi-organ failure, septic shock and death.
The latest figures estimate that 35,000 people die from sepsis in England each year. In children, the mortality rate is between 10-15%.
Chief Medical Officer Dame Sally Davies said that if action is not taken on antimicrobial resistance “deaths will go up and modern medicine as we know it will be lost”.
NHS England’s patient safety alert states that timely recognition and diagnosis of sepsis, quick involvement of experts and fast use of antibiotics could save 11,000 lives per year.
Derrick Crook, a professor of microbiology at the University of Oxford said that everyone is aware of the fact that antibiotics “work and they work well”.
However, he said that there is a “huge amount of learning to be done”.
Professor Crook said: “People are making alarming accusations that healthcare systems don’t treat with antibiotics well enough, at the same time as an initiative in the country to say that we should use them more.”
The patient safety alert released by NHS England calls sepsis a “time-critical medical emergence” which clinicians in primary, community care and the ambulance service should be aware of.
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