Antimicrobial resistance
noticeboard often has more impact than a dense monthly PDF.
Make shared decision-making part of the bundle Finally, Professor Gee underscored that prevention is not something done to patients but with them. Shared decision-making, explaining benefits, risks, alternatives and the option of doing nothing improves adherence and reduces unwarranted variation. In the prevention context, this can be as simple as confirming a patient understands why a nasal treatment is recommended, checking for barriers, and agreeing solutions.
Spotlight on Patient Experience The webinar also included Dionne McFarlane’s story which brought the patient view to life. Dionne described her experience following urinary retention, when she required catheterisation and subsequently experienced a pattern of recurrent urinary tract infections that became increasingly difficult to treat. Over time, empirical courses gave way to targeted therapies as sensitivities narrowed, and eventually even intravesical gentamicin instillations were stopped due to emerging resistance. The clinical picture spilled into everyday life:
recurrent GP and hospital visits, episodes of severe nausea and vomiting requiring anti- emetic support and the mounting anxiety of diminishing options. While professionals were trying to help, the pathway felt fragmented. Test results did not always translate into a clear, shared plan, terminology felt opaque at times, and family and friends struggled to grasp why a “simple UTI” required such complex management.
Amid this uncertainty, Dionne was told at one point that she was in “dangerous waters”, a phrasing that captured the gravity of AMR but also heightened the emotional load. Ultimately, she identified and accessed a specialist service for suspected embedded chronic UTI, commenced a structured regimen including methenamine and high-dose antibiotics with monitoring, and experienced fewer severe flares. The difference was not only clinical; it was also about having a coherent plan and a team that spoke plainly about options and contingencies. Her experience offers several practical lessons. First, acknowledge fear explicitly and early. Patients who hear that their infection is “resistant” will worry about escalation, hospitalisation and sepsis; naming those worries and outlining the plan reduces distress and improves adherence. Second, make information transparent by default. If there are findings
of significance in the notes, ensure they are explained in conversation and reflected in plain- English summaries. Third, provide actionable steps that patients can take so that the period between appointments does not feel like drift.
Conclusion Professor Gee’s message was straightforward: preventing infections is one of the most powerful AMR interventions available to peri- operative teams. The work is not mysterious, it is disciplined. Align with recognised guidance; plan for S. aureus; use decolonisation and chlorhexidine washes where indicated; and design pathways that make the right thing easy for patients and staff. Where mupirocin is used, couple it with stewardship and adherence support; where non-antibiotic technologies are trialled, do so within clear protocols and robust evaluation. Above all, prioritise reliable delivery over
novelty: a dozen small, well-executed steps consistently outperform a single, headline- grabbing initiative delivered inconsistently. Build simple feedback loops that teams actually use, celebrate incremental gains, and correct course quickly when slippage occurs. Dionne’s experience is a reminder of why this matters. Resistant infections unfold in real homes and workplaces, not just in clinics and theatres. When the system communicates clearly, offers practical support, and provides timely access to specialist expertise, patients feel safer and pathways flow better. When it does not, people are left to navigate complexity alone. By treating SSI prevention as stewardship, by simplifying and standardising what works, and by partnering with patients,
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organisations can deliver safer care today and preserve antimicrobial options for tomorrow. That is a compelling proposition for any service leader balancing quality, cost and public health responsibility.
CSJ
Reference 1. DHSC, Policy paper, Policy Paper: Confronting antimicrobial resistance 2024 to 2029. Accessed at:
https://www.gov.uk/government/ publications/uk-5-year-action-plan-for- antimicrobial-resistance-2024-to-2029/ confronting-antimicrobial-resistance-2024-to- 2029#the-threat-of-amr
About the author
Caterina Galani is a Global Product Manager for Molnlycke’s Antiseptics division. Holding managerial positions in marketing, business development and project management, she is passionate about infection prevention, making life better and safer for clinicians and patients alike.
Gorodenkoff -
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