Antimicrobial resistance
Working together against AMR
Caterina Galani, Global product manager, Mölnlycke, discusses the lessons learnt from the ‘Prevent, Protect, Provide’ webinar, led by Professor Christopher Gee, Consultant Trauma and Orthopaedic Surgeon and Associate Medical Director at NHS Golden Jubilee.
In October, Mölnlycke hosted the second webinar of its educational series “Prevent, Protect, Provide: Best-practice strategies against AMR”, which brought together clinical and patient voices to explore how peri- operative practice can meaningfully reduce antimicrobial resistance (AMR) while improving patient outcomes and delivering efficiencies in clinical settings. While the UK ranks highly in international tables in meeting the challenge of AMR, the latest available data shows that there estimated 7,600 deaths directly from infections resistant to antibiotics.1 The webinar, attended by almost 100 infection
professionals from across the NHS, was led by Professor Christopher Gee, Consultant Trauma and Orthopaedic Surgeon and Associate Medical Director at NHS Golden Jubilee, who set out a prevention-first approach that puts surgical site infection (SSI) reduction at the heart of stewardship. His presentation was rooted in pragmatism: fewer infections mean fewer antibiotics, fewer complications and less time in hospital. He emphasised that the evidence exists, guidelines are available, and the gains are within reach if services organise themselves to deliver reliably. The session also featured an interview with Dionne McFarlane, whose lived experience of a resistant urinary tract infection illustrated how AMR interacts with pathway design, communication and access to specialist expertise. Together, their perspectives set out a clear agenda: plan for prevention, standardise what works, support patients to do their part, and track results in a way that prompts continuous improvement.
12 key takeaways from Professor Gee’s presentation Treat SSI prevention as a core AMR intervention, not an adjunct The single most reliable way for surgical services to contribute to AMR stewardship is to prevent infections that would otherwise necessitate antibiotics. Professor Gee framed SSI prevention
as an AMR strategy in its own right. Each postoperative infection triggers diagnostic work-up, antimicrobials (often broad-spectrum while awaiting sensitivities), and follow-on risks such as Clostridioides difficile, line infections and readmissions. Conversely, when bundles reduce SSI rates, the downstream antibiotic exposure for that population drops. This reframing matters for governance and investment decisions as time spent perfecting pre-operative skin preparation, standardising nasal decolonisation, or tightening theatre discipline is not “nice-to-have” hygiene, but AMR control.
Evidence-based bundles work; implementation discipline is the differentiator Across specialties, multi-component SSI bundles consistently outperform individual measures. The challenge is operational: real-world teams must deliver several steps, often across organisational boundaries, to the right patient, in the right sequence, every time. Professor Gee highlighted that the barrier is less about “what” to do and more about making it reliably workable. Practical implications include
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simplifying instructions to patients, such as providing clear day-by-day checklists, building prompts into electronic pre-assessment, and aligning pharmacy and nursing workflows so that products are available when needed. Where compliance is weak, treat it like any other quality-improvement project: find the failure points, co-design fixes with users and test changes rapidly.
Reduce unwarranted variation by aligning with recognised guidance Variation persists between units in pre- operative preparation, screening policies and decolonisation practices. Professor Gee’s advice was to anchor local practice in recognised national and international guidance, then iterate based on local context. Most guidelines converge on the high-value elements, such as hand hygiene, appropriate prophylaxis, skin antisepsis, temperature control, glucose management and, where relevant, decolonisation. A practical approach is to adopt a baseline protocol aligned to current guidance, specify where local adaptation differs
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