title: Scottish Antimicrobial Prescribing Group (SAPG): development and impact of the Scottish National Antimicrobial Stewardship Programme.
abstract: In 2008, the Scottish Management of Antimicrobial Resistance Action Plan (ScotMARAP) was published by the Scottish Government. One of the key actions was initiation of the Scottish Antimicrobial Prescribing Group (SAPG), hosted within the Scottish Medicines Consortium, to take forward national implementation of the key recommendations of this action plan. The primary objective of SAPG is to co-ordinate and deliver a national framework or programme of work for antimicrobial stewardship. This programme, led by SAPG, is delivered by NHS National Services Scotland (Health Protection Scotland and Information Services Division), NHS Quality Improvement Scotland, and NHS National Education Scotland as well as NHS board Antimicrobial Management Teams. Between 2008 and 2010, SAPG has achieved a number of early successes, which are the subject of this review: (i) through measures to optimise prescribing in hospital and primary care, combined with infection prevention measures, SAPG has contributed significantly to reducing Clostridium difficile infection rates in Scotland; (ii) there has been engagement of all key stakeholders at local and national levels to ensure an integrated approach to antimicrobial stewardship within the wider healthcare-associated infection agenda; (iii) development and implementation of data management systems to support quality improvement; (iv) development of training materials on antimicrobial stewardship for healthcare professionals; and (v) improving clinical management of infections (e.g. community-acquired pneumonia) through quality improvement methodology. The early successes achieved by SAPG demonstrate that this delivery model is effective and provides the leadership and focus required to implement antimicrobial stewardship to improve antimicrobial prescribing and infection management across NHS Scotland.
authors.affiliation: Infection Unit, East Block, Level 4, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK. dilip.nathwani@nhs.net
authors.forename: Dilip
authors.initials: D
authors.lastname: Nathwani
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Sneddon
authors.forename: William
authors.initials: W
authors.lastname: Malcolm
authors.forename: Camilla
authors.initials: C
authors.lastname: Wiuff
authors.forename: Andrea
authors.initials: A
authors.lastname: Patton
authors.forename: Simon
authors.initials: S
authors.lastname: Hurding
authors.forename: Anne
authors.initials: A
authors.lastname: Eastaway
authors.forename: R Andrew
authors.initials: RA
authors.lastname: Seaton
authors.forename: Emma
authors.initials: E
authors.lastname: Watson
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gillies
authors.forename: Peter
authors.initials: P
authors.lastname: Davey
authors.forename: Marion
authors.initials: M
authors.lastname: Bennie
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects; D001424:Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology; D016360:Clostridioides difficile / Q000187:drug effects; D004352:Drug Resistance, Microbial; D004363:Drug Utilization / Q000592:standards*; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D009313:National Health Programs; D058996:Quality Improvement; D012606:Scotland
chemical_list: D000900:Anti-Bacterial Agents