Poster presentation at the Federation of Infection Societies (FIS) conference

As part of my Year 3 Student Selected Component (SSC) I completed an audit in the Acute Medical Unit (AMU) under the supervision of UHNM Consultant Microbiologist Dr Desai. The aim of the audit was to learn if current investigations, diagnosis and treatment for Common Acquired Pneumonia (CAP) patients comply with current British Thoracic Society (BTS) guidelines. After the four weeks completion of the audit we submitted to present at the FIS conference in Birmingham. The audit poster was titled “Antimicrobial stewardship can improve the management of pneumonia”.

Antimicrobial stewardship is an important topic currently with antimicrobial resistance becoming a real problem globally. In the audit, important findings were that CURB* scoring was not performed for all patients. Of 34 patients, only 2 had CURB scoring performed. 65% of antibiotic prescriptions didn’t meet BTS guidelines based on CURB severity of CAP. One of the core component of BTS guidelines for assessing severity alongside clinical judgement is CURB scoring. This poses huge a challenge for antimicrobial stewards. The hospital guidelines state that when prescribing an antibiotic for community acquired pneumonia the severity must be taken into account. Low, moderate and severe severity all have different antibiotics that should be prescribed. The audit found most doctors prescribed the strongest antibiotics and didn't take into account severity. Hence, it was strongly recommending the use of CURB scoring to document severity.

This SSC has given me a better insight into the diagnosing and management of community acquired pneumonia along with some of the difficulties that face clinicians when dealing with many ill patients with limited staff and time.

*CURB scoring is the BTS recommended system to determine the severity of CAP. The letters stand for Confusion, Urea, Respiratory rate and Blood pressure.

William Masson, Year 4 Medical Student