Revised antibiotic guidelines and enhanced stewardship was associated with a significant stepwise reduction in the use of cephalosporins and fluoroquinolones and a significant decrease in the incidence of CDI.

No abstract

Antimicrobial stewardship in the UK has evolved dramatically in the last 15 years. Factors driving this include initial central funding for specialist pharmacists and mandatory reductions in healthcare-associated infections (particularly Clostridium difficile infection). More recently, the introduction of national stewardship guidelines, and an increased focus on stewardship as part of the UK five-year antimicrobial resistance strategy, have accelerated and embedded developments. Antimicrobial pharmacists have been instrumental in effecting changes at an organizational and national level. This article describes the evolution of the antimicrobial pharmacist role, its impact, the progress toward the actions listed in the five-year resistance strategy, and novel emerging areas in stewardship in the UK.

A biomechanical study in vitro has evaluated a new modification of the core and peripheral suture technique for flexor tendon repair. Groups of repairs were conducted in cadaver tendons, using a core suture alone, a core suture with a simple running surface suture and a new modification involving a 'Halsted' horizontal mattress technique for the peripheral stitch. The Halsted modification increased the load at which a visible gap formed by 93%, the load at which a 2 mm gap formed by 77%, and the maximum strength by 89%. This increase was due to the technique; it did not depend on the suture material used. The bulk of the tendon repair was not significantly greater with the Halsted modification.