What resources do NHS commissioning organisations use to support antimicrobial stewardship in primary care in England?

Rosalie Allison*, Donna Lecky, Elizabeth Beech, Diane Ashiru Oredope, Céire Costelloe, Rebecca Owens, Cliodna McNulty

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Professional education and public engagement are fundamental components of any antimicrobial stewardship (AMS) strategy. The National Institute for Health and Care Excellence (NICE), Public Health England (PHE), Health Education England (HEE) and other professional organisations, develop and publish resources to support AMS activity in primary care settings. The aim of this study was to explore the adoption and use of education/training and supporting AMS resources within NHS primary care in England. Questionnaires were sent to the medicines management teams of all 209 Clinical Commissioning Groups (CCGs) in England, in 2017. Primary care practitioners in 168/175 (96%) CCGs received AMS education in the last two years. Respondents in 184/186 (99%) CCGs reported actively promoting the TARGET Toolkit to their primary care practitioners; although 137/176 (78%) did not know what percentage of primary care practitioners used the TARGET toolkit. All respondents were aware of Antibiotic Guardian and 132/167 (79%) reported promoting the campaign. Promotion of AMS resources to general practices is currently excellent, but as evaluation of uptake or effect is poor, this should be encouraged by resource providers and through quality improvement programmes. Trainers should be encouraged to promote and highlight the importance of action planning within their AMS training. AMS resources, such as leaflets and education, should be promoted across the whole health economy, including Out of Hours and care homes. Primary care practitioners should continue to be encouraged to display a signed Antibiotic Guardian poster as well as general AMS posters and videos in practice, as patients find them useful and noticeable.

Original languageEnglish
Article number158
Issue number4
Publication statusPublished - Apr 2020

Bibliographical note

Funding Information:
Conflicts of Interest: Céire Costelloe is funded through a personal NIHR fellowship (CDF-2016-09-015). Cliodna McNulty, Donna Lecky and Rosalie Allison are employed by Public Health England (PHE) and work on the TARGET (Treat Antibiotics Responsibly, Guidance, Education, Tools) programme. Rebecca Owens was employed by PHE as the TARGET project manager. Cliodna McNulty is the lead for development of the PHE Managing Common Infections guidance. Diane Ashiru-Oredope is the pharmacist lead for AMR in PHE. No other authors declare competing interests.

Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.


  • Antibiotic guardian
  • Antimicrobial resistance
  • Health education
  • Target
  • Training


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