The RCGP TARGET [Treat Antibiotics Responsibly, Guidance, Education & Tools ] Antibiotic Toolkit has been refreshed and updated in recent months.
The updated toolkit now includes a comprehensive guide to the available resources with advice and tips on using them in practice.
Among the refreshed resources are:
The various TYI leaflets are available in simplified pictorial form and in a range of languages.
Healthcare Professionals can sign up to receive quarterly newsletters and to be notified of changes and updates to the TARGET Toolkit HERE.
Public Health England’s management of infection guideline recommends the use of FeverPAIN score in the assessment of acute sore throats.
The score consist of five items:
- Fever in last 24 hours
- Attend rapidly under 3 days
- Inflamed tonsils
- No cough or coyza
- Score 0-1 = 13-18% streptococci, use NO antibiotic strategy
- Score 2-3 = 34-40% streptococci, use 3 day back-up antibiotic prescription strategy
- Score ≥4 = 62-65% streptococci, use immediate antibiotic if severe, or 48 hour short back-up prescription
The Fever PAIN score was derived from a cohort study including 1760 adults and children aged 3 and over. The score was tested in a trial comparing three prescribing strategies, empirical delayed prescribing, use of the score to direct prescribing or combination of the score with use of a near patient test (NPT) for streptococcus. Using the score resulted in more rapid symptom resolution and reduced prescribing of antibiotics (both reduced by one third). The addition of the NPT did not confer any additional benefit.
Using the online FeverPAIN score tool enables rapid calculation of the score, gives a treatment guide and provides a summary to cut and paste in the notes.
TARGET audit toolkits and action planning
TARGET have developed a series of audits to assess antibiotic prescribing against national guidelines. For more information go to the TARGET website, or click on the links below to download audit templates.
Sore Throat Audit: Use this audit template to evaluate antibiotic prescribing for sore throat symptoms against NICE and PHE clinical guidelines or local infection management guidelines.
Urinary Tract Infection Audit: Use this audit template to evaluate the diagnosis of uncomplicated urinary tract infections using urine dipsticks and/or urine cultures and to assess antibiotic prescribing using Public Health England guidance on the diagnosis and antibiotic treatment of UTIs.
Otitis Media Audit: Use this audit template to evaluate antibiotic prescribing for otitis media symptoms against NICE and PHE clinical guidelines or local infection management guidelines.
Acute Otitis Externa Audit: Use this audit to evaluate antibiotic prescribing for acute otitis externa symptoms against Public Health England (PHE) Management of Infection Guidance for Primary Care.
Acute Cough Audit: Use this audit template to evaluate antibiotic prescribing for acute cough symptoms against NICE and PHE clinical guidelines or local infection management guidelines.
Acute Rhinosinusitis Audit: Use this audit template to evaluate antibiotic prescribing for acute rhinosinusitis symptoms against NICE and PHE clinical guidelines or local infection management guidelines.
Scottish Antimicrobial Prescribing Group Primary Care Audits
The Scottish Antimicrobial Prescribing Group have developed a range of interventions to support the reduction of unnecessary use of antibiotics for self-limiting respiratory tract infections. These resources are available on the SAPG website.
Treating your Infection patient leaflet
The Patient Treating Your Infection leaflet is a useful tool for clinicians to use within consultations for patients who do not require an antibiotic prescription for their infection. It includes information on illness duration, self-care advice and advice on when to re-consult. Use of this leaflet has been approved by PHE, RCGP, BSAC, NHS Scotland, RCN, IPS and BIA.
Urinary Tract Infection Leaflet
The Patient Urinary Tract Infection (UTI) Information leaflet has been designed to be used during consultation with women who are experiencing non complicated UTIs. It is a useful tool for clinicians to use where the clinician feels that the patient does not require an antibiotic prescription. It includes information on illness duration, self-care advice, prevention advice and advice on when to re-consult. Use of this leaflet has been approved by PHE, RCGP, NHS Wales, Scottish UTI Network (SUTIN), RPS and BIA.
When Should I Worry? Booklet for Parents and Carers
The ‘When Should I Worry?’ booklet provides information for parents about the management of respiratory tract infections such as coughs, colds, sore throats and ear aches in children. It is designed to be shared in consultations.
The booklet can be downloaded free of charge from the When should I worry? website www.whenshouldiworry.com. Practices can also order colour glossy booklets (in bundles of 50) from the RCGP bookshop.
The NECS Medicines Optimisation Team hosted an antimicrobial stewardship event on 19th November 2015, during World Antibiotic Awareness Week and supporting Public Health England’s Antibiotic Guardian campaign.
Key note presentations
Antimicrobial Resistance and Stewardship: a national picture Stuart Brown, HCAI and AMR Project Lead, NHS England, and Lead Antimicrobial Pharmacist, County Durham & Darlington NHS Foundation Trust
Antibiotic Sensitivity in the North East with a Focus on UTI Professor Kate Gould, Lead Public Health Microbiologist North East England, Public Health England, and Dr Simon Howard, Public Health Speciality Registrar, Public Health England
Supporting Appropriate Antibiotic Prescribing in Primary Care Professor Cliodna McNulty, Head of Primary Care Unit, Public Health England
Clostridium difficile in Primary Care Dr Deepa Nayar, Consultant Microbiologist, County Durham and Darlington NHS Foundation Trust
Management of Suspected Bacterial Urinary Tract Infections in Older People Jane Lawson, Infection Prevention and Control Nurse, Durham Dales, Easington and Sedgefield CCG
Planning the Delivery of TARGET Antibiotics Toolkit Professor Cliodna McNulty, Head of Primary Care Unit, Public Health England
Troubled Waters: Urinary Tract Infection in Older People Benjamin Kelly-Fatemi, Lead Pharmacist for Newcastle Care Homes Project, NECS