EWMA 2020, 13-15 May

Antimicrobial Stewardship

EWMA is continuously contributing to the EU’s commitment to face the challenges of antimicrobial resistance. A number of initiatives such as the publication of the EWMA Document “Antimicrobials and Non-healing Wounds” have been successfully accomplished, and parallel to this, EWMA has been working on establishing contact and partnerships with organisations and groups that have mutual and synergistic objectives on the antimicrobial resistance agenda.




Antimicrobial stewardship in wound care

Non-antibiotic antimicrobial interventions and antimicrobial steward in wound care

Control of wound infection today relies largely on antibiotics, but the continual emergence of antibiotic-resistant microorganisms threatens a return to the pre-antibiotic era when physicians used antiseptics to prevent and manage infection. Some of those antiseptics are still used today, and others have become available. With the prospect of a post-antibiotic era looming, ways to maintain and extend our antimicrobial armamentarium must be found. In this narrative review, current and emerging non-antibiotic antimicrobial strategies will be considered and the need for antimicrobial stewardship in wound care will be explained.


A Position Paper from the British Society for Antimicrobial Chemotherapy and European Wound Management Association

Under the umbrella of the EWMA Antimicrobial Stewardship Programme a joint position paper with the British Society of Antimicrobial Chemotherapy (BSAC) has been published.

About the position paper

With the growing global problem of antibiotic resistance it is crucial that clinicians use antibiotics wisely, which largely means following the principles of antimicrobial stewardship (AMS). Treatment of various types of wounds is one of the more common reasons for prescribing antibiotics. This paper is aimed at providing clinicians an understanding of:

  • The basic principles of why AMS is important in caring for patients with infected wounds
  • Who should be involved in AMS
  • How to conduct AMS for patients with infected wounds.

The paper is elaborated by a group of experts in infectious diseases/clinical microbiology (from the British Society for Antimicrobial Chemotherapy) and wound management (from the European Wound Management Association) who, after thoroughly reviewing the available literature and holding teleconferences, jointly produced this document.

The position paper concludes

  • All open wounds will be colonized with bacteria, but antibiotic therapy is only required for those that are clinically infected.
  • Therapy is usually empirical to start, but definitive therapy should be based on results of appropriately collected specimens for culture.
  • When prescribed, it should be as narrowly focused, and administered for the shortest duration, as possible.
  • AMS teams should be interdisciplinary, especially including specialists in infection and pharmacy, with input from administrative personnel, the treating clinicians and their patients.
  • Available evidence is limited, but suggests that applying principles of AMS to the care of patients with wounds should help to reduce the unnecessary use of systemic or topical antibiotic therapy and ensure the safest and most clinically effective therapy for infected wounds.

Download the paper free of charge via Journal of Antimicrobial Chemotherapy

Addressing the urgent need for antimicrobial stewardship in wound care

Given the societal value of antimicrobials and their diminishing effectiveness due to antimicrobial resistance, the WHO is now recommending member states to strengthen national stewardship. Still, there are currently no international or coordinated legislative or regulatory mandates designed to optimize the use of antimicrobials through stewardship.Antimicrobial stewardship programmes are increasingly advocated as a means to decrease misuse of antimicrobial agents. Along with infection prevention and control, hand hygiene and surveillance, antimicrobial stewardship is considered a key strategy in local and national programmes to prevent the emergence of antimicrobial resistance and decrease preventable healthcare associated infection.On that background EWMA is now taking the lead and introducing a tailored stewardship concept to wound care practitioners.



EWMA’s Antimicrobial Stewardship programme

The overall aim of the stewardship programme is to reduce inappropriate use of antibiotics by promoting, facilitating and teaching the use of antibiotic alternatives in wound management across all healthcare settings.The programme aim is supported by the following three programme deliverables:


Policy statement

Together with the British Society for Antimicrobial Chemotherapy (BSAC) EWMA is writing a Policy Statement on antimicrobial stewardship in wound management across all heath care settings.

Author group

  • BSAC: Dilip Nathwani (Senior Author), Matthew Dryden, Andrew Seaton
  • EWMA: Finn Gottrup (Senior Author), Benjamin Lipsky (Lead/Editor), Jan Stryja

The document is to be published will be published in the Journal of Antimicrobial Chemotherapy in the spring of 2016.


Review of current non-antibiotic antimicrobial technologies

Development and publication of a document reviewing current non-antibiotic antimicrobial technologies for wound management including antiseptic agents, antimicrobial dressings and devices.·   Establishment of expert consensus on key elements of evidence-based best practice infection control measures


The aim is to qualify the participants to influence the use of antimicrobial agents and devices. This is achieved by providing concrete tools and ideas that supports the healthcare team approach to antimicrobial stewardship in daily practice.

  • Online training module on antimicrobial stewardship in wound care
  • Dedicated symposia at upcoming EWMA conferences
  • Regional symposia on antimicrobial stewardship in collaboration with EWMA Cooperating Organisations an International Partner Organisation
  • EWMA’s EU advocacy activities

Programme Target Group: Health professionals involved with wound care - doctors, nurses, pharmacists, microbiologists a.o. Policy makers, such as clinical administrators or managers at local, regional or national level. Focus is on the health professional’s role in the area of appropriate use of antimicrobials across all health care settings.


Joint BSAC/EWMA Symposiums on Antimicrobial Stewardship in Wound Care

3 - 5 May during the EWMA 2017 conference in Amsterdam

I 2017 a joint symposium was held between EWMA and the British Society for Antimicrobial Chemotherapy. The symposium was organised into two sessions. The first focused specifically on wound care issues and the second concerned antimicrobial stewardship programmes. The following topics were discussed:

  • Non-antibiotic antimicrobial interventions in wound care: agents, resistance and beyond!
  • Non-antibiotic alternatives in clinical practice
  • What can we learn from national approaches to AMS
  • Euregional AMS strategy: an integrated stewardship model: antimicrobial, infection prevention and diagnostics (AID)
  • UK strategy for combating resistance.

Rose Cooper, Professor of Microbiology, and representing BSAC, has published a meeting report in Wounds International. The article is avaliable for free download here: http://www.wintjournal.com/journal-content/view/meeting-report-antimicrobial-stewardship-in-wound-management


Thursday 11 May, during the EWMA 2016 Conference in Bremen

Also in 2016 EWMA joined forces with the British Society for Antimicrobial Chemotherapy for an educational event encompassing the following topics:

  • Biofilm formation and the role of bacterial biofilm in chronic wounds
  • Defining antimicrobial stewardship in wound  management
  • Presentation of the BSAC/EWMA Position paper on antimicrobial stewardship in wound management
  • Primary prevention and antimicrobial alternatives in wound management
  • The nurse’s role in antibiotic stewardship.

Project sponsors

This project is supported by an unrestricted grant from: