At an INTEGRATE AMR networking meeting, Warwick Medical School's Dr Esther Robinson brought home just how serious a problem antimicrobial resistance poses from a clinician's perspective.
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On the Edge of the Abyss
1. On the edge of the abyss
Dr Esther Robinson 1st March 2016
2. View from the clinical frontline
Postcard from the
edge
Into the Void
Bridging the Gap
3. It all starts with a patient…
Mr S, DOB xx.xx.xx
Specimen type: nephrostomy urine
Result: E.coli isolated
CPE isolated
Positive for OXA-48, sent to
reference laboratory for confirmation
13. Holding back the tide
• CPE screening: national policy, local
variety in implementing (money)
• Infection control measures: failing?
• Stewardship: balancing on the edge of
surviving sepsis and reducing
antimicrobial use
14. Bridging the gap 1: teetering on
the brink
• How do we use existing antibiotics optimally
to retard resistance?
• Can new/ rapid diagnostics improve control of
spread/ inform better antimicrobial use?
15. Bridging the gap 2: beyond the
abyss
• New drugs: prevent spread of resistance
– Can we cure plasmid in vivo or out-compete it?
– Target drugs to site of infection: limit collateral
damage, selection pressure
• New drugs: conventional antibacterials and
alternatives