C difficile Post Infection Review feedback from the Infection Prevention & Control Team, Wirral Community Trust
There were 6 reported cases of community attributed clostridium difficile infection in January 2018. The key learning points from these reviews were:
- Stool samples obtain promptly as indicated.
Areas of good practice identified from these reviews were as follows:
- Prompt commencement of treatment for C.difficile based on clinical presentation.
- Prompt clinical assessment of patients.
- Antibiotics prescribed in line with antimicrobial guidelines.
Wirral Antimicrobial Guidelines and Management of Common Infections in Primary Care – partial update 2018
The primary care antibiotic guidelines have been partially updated to reflect a number of changes to national guidelines.
Prescribers should ensure that they have access to the most recent version of the guidelines. These can be found at this link.
There is also a one page summary sheet for reference.
Wirral CCG has agreed to fund paper booklets to support prescribers with the appropriate use of antibiotics. These are expected to be available to practices by the end of April 2018.
Controlled Drugs Update
Regulation 28: Controlled Drugs (CD) Clear Dosing Instructions
NHS England has received a coroner’s report relating to a patient who was prescribed liquid morphine (schedule 5 CD) by their GP and later died. The coroner’s concern was that neither the individual unit dose nor the maximum total daily dose was printed on the label of the medication.
NHS England requests that all healthcare professionals involved in the prescribing and dispensing of prescriptions take further action to prevent future deaths. Please refer to the CD Dosing Instruction Memo for more information and advice.
Benzodiazepines and Suicide Risk: Follow up from Coroner Regulation 28 report to prevent future deaths
Risks associated with benzodiazepine prescribing have been known for many years. There has been a recent Coroner’s Regulation 28 report from NHS Mental Health to raise awareness of the potential risks of suicide associated with benzodiazepine prescribing and withdrawal.
In line with the NICE and British Association of Psychopharmacology guidance, prescribers should assess the risks for all patients who are prescribed benzodiazepines and review them on a regular basis. In particular, patients who are withdrawing from benzodiazepines should be closely monitored.
Attempting to withdraw patients from benzodiazepines should be a gradual process and may take from three months up to a year or longer. The guidance at the link below produced by the Medicines Management and Optimisation team should help guide prescribers on the safe withdrawal of benzodiazepines.
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