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TARGET Antibiotic Toolkit

TARGET-logoWhat is TARGET?

TARGET stands for: Treat Antibiotics Responsibly, Guidance, Education, Tools. The toolkit helps influence prescribers’ and patients’ personal attitudes, social norms and perceived barriers to optimal antibiotic prescribing. It includes a range of resources that can each be used to support prescribers’ and patients’ responsible antibiotic use, helping to fulfil CPD and revalidation requirements.

Who is it for, and how can it be used?

The toolkit is designed to be used by the whole primary care team within the GP practice or out of hours setting. These resources can be used flexibly, either as standalone materials or as part of an integrated package. We do recommend that ALL resources are used if this is feasible. Using the TARGET Antibiotics Toolkit resources will enable primary care organisations to demonstrate compliance with the Health and Social Care Act 2008: Code of Practice on the prevention and control of infections and related guidance. 

TARGET toolkit updates and news

Updates

All TARGET resources are reviewed every 2 – 4 years, depending on the specific resource, or more frequently if there are significant developments in the field. Any resource changes will be highlighted here

News

We publish 4 TARGETantibiotics newsletters a year (February, May, September, November) highlighting resource updates, new developments, publications and any planned future work that you may wish to be involved in.  If you would like to be mailed the newsletter please sign up here..

Treating your infection - UTI for older adults leaflet

We are delighted to announce that we have finalised the development of a UTI information leaflet for older adults who have urinary symptoms or may be at risk of future UTIs. The leaflet may also be used during primary care consultations to facilitate dialogue between a patient and their GP on specific topics like treatment or safety netting. It is important that the leaflet is used as a tool to interact with patients, rather than as a ‘parting gift’.  The UTI for older adults information leaflet can be found in the “leaflets to share with patients” section of the TARGET website.

We are happy to receive feedback about how you have used or implemented this leaflet and any constructive comments on how it can be improved. Please contact the TARGET team via email at TARGETantibiotics@phe.gov.uk.

UTI Resource Suite

This section of the TARGET website has been designed to support the Government’s ambition to halve inappropriate prescribing of antibiotics by 2020 and to help facilitate the newly launched 2017-19 Quality Premium targets related to reducing gram-negative bloodstream infections (GNBSIs) and inappropriate antibiotic prescribing in at risk groups.
 
We have grouped all of the TARGET resources focussing on Urinary Tract Infections (UTIs) in one place to make it easier for you to find them all. 

Patient Facing Materials

Treating your infection - URINARY TRACT INFECTION (TYI-UTI) leaflet

The TYI-UTI patient Information leaflet has been designed to be used with women who are experiencing urinary symptoms suggesting non complicated UTIs.

This leaflet supports implementation of recommendations in the NICE guidelines on processes for antimicrobial stewardship and behaviour change for antimicrobial stewardship. 

For leaflet translation into various languages please visit the leaflets to share with patient’s section of the TARGET website. 

Treating Your Infection UTI leaflet FOR OLDER ADULTS and those who care for them 

The leaflet can be used to either to provide information on UTIs to those at risk or care staff may wish to share this leaflet with older adults in their care and/or their relatives. The leaflet may also be used during primary care consultations to facilitate dialogue between a patient and their GP on specific topics like treatment or safety netting. It is important that the leaflet is used as a tool to interact with patients, rather than as a ‘parting gift’. 

Diagnostic Tools

A series of quick reference tools for diagnosis of UTIs including knowing when to use the microbiology laboratory and how to understand results. Quick reference tools are available for: 

  • Women (under 65 years) with suspected UTI
  • Older person (over 65 years) with suspected UTI
  • Children (under 16 years) with suspected UTI

Audit templates

Templates for accurate and easy auditing, including Read codes, current guidance and action plans. Use the UTI audit template to assess your management of UTIs against current local and/or national guidelines. 

Training resources

  • Managing UTI eModule explains the importance and appropriateness of diagnostics and offers advice on how to assess and treat patients with a range of urinary symptoms. 

  • TARGET webinar on UTIs highlights simple key actions to help improve your antibiotic prescribing whilst improving the patient experience and their self-care, therefore freeing up your time. 

  • The TARGET antibiotic presentation core slides lasts 60 minutes and includes a clinical scenario on UTIs, slide notes and references.

     

Leaflets to share with patients

TARGET treating your infection (TYI) leaflets

The TYI patient information leaflets are designed to be shared with patients during the consultation and aim to facilitate communication between prescriber and patient, and increase patient’s confidence to self care. The leaflets include information on illness duration, self-care advice, prevention advice and advice on when to re-consult. For any leaflet queries please contact us: TARGETantibiotics@phe.gov.uk

Treating your infection - URINARY TRACT INFECTION (TYI-UTI) leaflet

Treating your infection - Urinary Tract Infection Image

The TYI-UTI patient Information leaflet has been designed to be used with women who are experiencing urinary symptoms suggesting non complicated UTIs.

This leaflet supports implementation of recommendations in the NICE guidelines on processes for antimicrobial stewardship and behaviour change for antimicrobial stewardship.

TYI-UTI leaflet translations

Treating your infection – URINARY TRACT INFECTION FOR OLDER ADULTS leaflet

The older adult UTI patient Information leaflet has been designed to be used with older adults who are at risk of UTI, experiencing urinary symptoms or have been diagnosed with UTI

Treating your infection – RESPIRATORY TRACT INFECTION (TYI-RTI) leaflet

The TYI-RTI patient Information leaflet has been designed to be used with patients who are experiencing self limiting URTIs.

This leaflet supports implementation of recommendations in the NICE guidelines on processes for antimicrobial stewardship, behaviour change for antimicrobial stewardship and antibiotic prescribing for respiratory tract infections.

 TYI-RTI leaflet translations

TYI-RTI leaflet for other clinical settings 

TYI-RTI pictorial leaflet – simplified version 

Treating your infection - Respiratory Tract Infection Pictorial leaflet

Other useful leaflets (not developed by TARGET)

Public Health England Stool collection leaflet (click on the picture to download the leaflet)

The stool collection leaflet is a step-by-step guide illustrating how to collect a stool sample for microbiological examination.

Public Health England stool collection leaflet - French

Antibiotic guardian leaflet (click on the image to download the leaflet)

Part of the dental antimicrobial stewardship toolkit for primary care, this leaflet highlights why antibiotics don't cure toothache and provides safety netting advice. 

When should I worry? Booklet for parents and carers (click on the image to download the booklet). For other languages please visit the When Should I Worry website.

The 'When Should I Worry?' booklet provides information for parents about the management of respiratory tract infections such as coughs, colds, sore throats and ear aches in children. It is designed to be shared in consultations. 

Caring for children with coughs leaflet (click on the image to download the leaflet)

This leaflet contains information about how to look after a child who has a cough (not due to asthma).

Get well soon without antibiotics leaflet (click on the image to download the leaflet)

This leaflet, produced by the Department of Health, explains the need to get the right treatment for common illnesses such as colds and coughs without encouraging antibiotic resistance. It is available in different languages and is suitable for distribution in waiting areas.

Antibiotics Don’t Cure Toothache (click on the image to download the leaflet)

Part of the dental antimicrobial stewardship toolkit for primary care, this leaflet highlights why antibiotics don't cure toothache and provides safety netting advice. 

 

Self-care forum fact sheets

The Self-Care Forum is dedicated to helping people take care of themselves and as such, have created a series of self-care fact sheets for common ailments which aim to help clinicians and patients discuss issues around self-care during consultation and especially how to handle the symptoms in the future. 

Resources for clinical and waiting areas

Posters and videos for use in clinical areas to raise awareness of the importance of prescribing antibiotics appropriately. The resources can make a difference to the patients’ expectations on antibiotic prescribing.

Posters

Click on the image to download the resource

    awareness 

   

Videos 

Access the Department of Health videos to be displayed on TVs in patient waiting areas: 

Click on the image to download the resource

Department of Health

Health Education England (HEE) 

The HEE antimicrobial resistance animation intends to assist prescribers when they are faced with somebody who incorrectly feels they should be prescribed an antibiotic. 

Posters and videos for use in clinical areas to raise awareness of the importance of prescribing antibiotics appropriately. The resources can make a difference to the patients’ expectations on antibiotic prescribing.

Posters

Click on the image to download the resource

awareness

 

Videos 

Access the Department of Health videos to be displayed on TVs in patient waiting areas: 

Click on the image to download the resource

Department of Health

Health Education England (HEE) 

The HEE antimicrobial resistance animation intends to assist prescribers when they are faced with somebody who incorrectly feels they should be prescribed an antibiotic. 

 

 

Posters and videos for use in clinical areas to raise awareness of the importance of prescribing antibiotics appropriately. The resources can make a difference to the patients’ expectations on antibiotic prescribing.

Posters

Click on the image to download the resource

awareness

 

Videos 

Access the Department of Health videos to be displayed on TVs in patient waiting areas: 

Click on the image to download the resource

Department of Health

Health Education England (HEE) 

The HEE antimicrobial resistance animation intends to assist prescribers when they are faced with somebody who incorrectly feels they should be prescribed an antibiotic. 

 

 
 

 

Audit toolkits and action planning

There are 5 antibiotic prescribing audits in the TARGET toolkit; Acute sore throat, otitis media, acute sinusitis, acute cough, and UTI. The audit templates allow users to input their consultation records for a particular condition to asses their management of infection and antibiotic prescribing against current local and/or national guidelines. The audit tools allow prescribers to compare their prescribing decisions with local guidance and will support identification of areas for quality improvement.  

Acute sore throat audit

Acute otitis media audit

Acute sinusitis audit

Acute cough audit

UTI audit

If you have any comments or feedback please contact us: TARGETantibiotics@phe.gov.uk 

Antibiotic and diagnostic quick reference tools

Summary of antimicrobial prescribing guidance - managing common infections

A summary of antimicrobial prescribing guidance produced by Public Health England in collaboration with the British Society for Antimicrobial Chemotherapy, the British Infection Society and the Royal College of General Practitioners for managing common infections for consultation and local adaptation. The guidance covers the appropriate use of antibiotics and antifungals and can be adapted locally, includes references and rationale and covers 

  • Upper Respiratory Tract Infections
  • Lower Respiratory Tract Infections
  • Urinary Tract Infections
  • Gastrointestinal Tract Infections
  • Genital Tract Infection
  • Meningitis
  • Skin and Soft Tissue Infections 
  • Eye Infections
  • Dental Infections

Laboratory diagnosis and treatment tools

A series of quick reference tools for diagnosis of infectious disease including knowing when to use the microbiology laboratory and how to understand results. Quick reference tools are available for 

  • Abnormal Vaginal Discharge
  • Chlamydia Trachomatis 
  • Fungal Skin and Nail Infections 
  • Infectious Diarrhoea 
  • Helicobacter Pylori in Dyspepsia 
  • Urinary Tract Infection
  • Venous Leg Ulcers

Self Assessment Checklist Antimicrobial Stewardship

Checklist to measure your current antibiotic prescribing practice against others in your region and nationally

This tool is a short questionnaire for use by GP practices and Commissioning groups to assess antibiotic prescribing. Once you have completed this questionnaire you will be able to compare your results to other practices in your area, and nationally. Go to the information icons to find suggestion on what you can do to achieve each point.

Training Resources

The following FREE training resources aim to provide up to date information and an evidence base to support optimal antibiotic prescribing. They will also help prescribers to help meet CPD and revalidation requirements. 

TARGET training resources

TARGET Antibiotic Webinar Series

This series of 7 TARGETantibiotics webinars, now available as un-facilitated learning courses, highlights simple key actions to help improve your antibiotic prescribing whilst improving the patient experience and their self-care, therefore freeing up your time.  

TARGET “why and how to achieve optimal prescribing” group training presentation

This presentation aims to provide up to date evidence for primary care clinicians about why optimising antibiotic prescribing is important and how this can be achieved. The presentation is designed to be delivered by GPs, microbiologists or medicine managers with an interest in antibiotic use however can be used by less experienced presenters.

TARGET Antibiotic Resistance in Primary Care eModule

This course will equip you with tools for improving your antibiotic prescribing and assist you in identifying the need for optimised antibiotic prescribing. Evidence showing the link between prescribing and resistance rates in GP patients is explored. 

RCGP learning e-modules

Other useful training (not developed by TARGET)

  • STAR: Stemming the Tide of Antibiotic Resistance: Developed buy Cardiff University, this eModule  focuses on antibiotic resistance (and its link with practice prescribing) and practical techniques for improving consultations for common infections.  
  • Antimicrobial Stewardship: Managing Antibiotic Resistance, developed by BSAC and the University of Dundee. Understand antibiotic resistance, and how antimicrobial stewardship can slow down or reduce it, with this free online course.

Health Education England 

  • Reducing Antimicrobial Resistance developed to support all health and social care staff understands the threats posed by antimicrobial resistance and ways they can help to tackle it. 

NICE/BMJ learning

NICE has developed a series of FREE open access online education tools in collaboration with BMJ Learning. The toolkit also supports the recommendations made in the NICE Antimicrobial stewardship: systems and processes for effective antimicrobial medicine use guidelines, published August 2015. It also supports the Antimicrobial stewardship NICE quality standard, published April 2016.

Antibiotic Prescribing Data

  • Fingertips Public Health England AMR local indicators provide CCG and practice level data to enable action planning.
  • PrescQIPP is an NHS funded not-for-profit organisation, produce evidence-based resources and tools for primary care commissioners, and provide a platform to share innovation across the NHS. 
  • OpenPrescribing makes it easier for GPs, managers and everyone to explore NHS data.
  • ePACT/ePact2 is an application which allows authorised users to electronically access prescription data, allowing access to real time online analysis of the previous sixty months prescribing data held on NHS Prescription Services' prescribing database.

Resources for Commissioners and TARGET trainers

Here are a series of resource documents to aid commissioners and TARGET trainers with the implementation of the TARGET resources.

Why run a TARGET workshop in my area?

A randomised controlled trial (RCT) of the local trainer led “TARGET” antibiotic interactive workshops showed that the workshops can help improve antibiotic use, and therefore should be considered as part of any national antimicrobial stewardship initiatives. Click here to read the full published results. 

TARGET Approved Trainers

Do you need a TARGET trainer to help facilitate the delivery of a TARGET workshop in your area? Visit the TARGET trainer section of the website to find a trainer local to you. These trainers have been trained by the TARGET team to deliver the workshop and facilitate the development of an antimicrobial stewardship plan within GP practices. 

Guidance for Commissioners and Trainers 

The guidance for commissioners and trainers resource  contains contains detailed information about the background to the TARGET resources, how they can be used in primary care as well as a detailed breakdown on how to facilitate your own TARGET workshop. 

Trainers and commissioners background presentation

The trainers and commissioners background presentation helps to explain to trainers how to roll out your local plan. 

Self assessment checklist  

The self assessment checklist helps to measure your current antibiotic prescribing practice against others in your region and nationally. Use it annually as a tool to measure any improvement in your own antibiotic prescribing. 

TARGET antibiotics workshop - group training

This modifiable 60 min presentation includes slide notes and references. It can be used as the basis of a group workshop which can be delivered by an approved TARGET trainer or anyone with an interest in antibiotic prescribing, for example, GPs, medicine managers or microbiologists.

The presentation covers information and tools that help influence social norms around antibiotic prescribing, clinicians' and patients' personal attitudes to antibiotic resistance, and suggests ways of decreasing barriers to appropriate antibiotic prescribing, with action planning.

We suggest that to maximise its effectiveness 

  • all primary care staff in the practice or out of hours setting are invited 
  • Practice antibiotic prescribing data are available and discussed
  • The resources on the website are readily available to display
  • The presenter is familiar with the local antibiotic guidance
  • There is enough time for action planning

Why use the TARGET antibiotics toolkit

Read an article about the TARGET toolkit in Commissioners Journal

TARGET Approved Trainers

Do you need a TARGET trainer to help facilitate the delivery of a TARGET workshop in your area? See the current list of approved trainers here. 

What does approved TARGET trainer status mean?

These trainers have been trained and approved by the TARGET team to deliver the workshop and facilitate the development of an antimicrobial stewardship plan within GP practices. All listed approved TARGET trainers have facilitated the delivery of at least one other TARGET workshop in their area. 

How can I get approved TARGET trainer status?

To become an approved TARGET trainer you must: 

  • Attend a half day TARGET workshop* followed by a TARGET train the trainer workshop.
  • Carry out a pre and post workshop attendance Self Assessment Checklist on your own prescribing
  • Deliver the TARGET workshop in your own practice within 6 months of receiving the training
  • Carry out a pre and post workshop delivery audit on at least 2 of the clinical scenarios (UTI, sore throat, acute cough, otitis media, sinusitis, skin infection) covered by the TARGET workshop in your practice. 

Once all documents have been returned to the TARGET training co-ordinator and reviewed, participants will receive their approved trainer status and accompanying resources.

*These TARGET workshops are FREE to attend, although a £50 admin charge will be applied for those who fail to attend without giving at least 24hrs notice. Workshops are held in Gloucester Royal Hospital twice a year. To book a place at any of these workshops please contact us at TARGETantibiotics@phe.gov.uk. 

What are the benefits of becoming an approved TARGET trainer?

 The training and continued learning required in order to become a TARGET approved trainer can help fulfil your professional CPD and validation requirements. The ongoing developmental work you do in practice can also help facilitate some of the CQC Key lines of enquiry for healthcare services. 

Trainer film

This short film for trainers outlines what is required of a trainer and how you can get the most out of your TARGET workshop delivery. The film is divided into sections which cover:

  • The TARGET Guide for commissioners and Trainers on the TARGET workshop and resources 
  • A background presentation to help explain how to roll out your local plan
  • How to prepare and modify your TARGET presentation
  • What to do following training to ensure that your training has positive outcomes

     

Useful links

  • Antibiotic Guardian - The Antibiotic Guardian campaign encourages the general public and health professionals to pledge to use antibiotics more responsibly.
  • Bristol University resources on caring for children with coughs - This website was created by a collaboration of researchers and parents who talked to lots of parents about what information they wanted to know when their child had a cough.
  • The British Infection Association (BIA) - The BIA aims to promote the science and practice of medicine in relation to infection, to support all infection specialists and trainees, and to further research into infection.
  • The British Society for Antimicrobial Chemotherapy (BSAC) - BSAC exists to facilitate the acquisition and dissemination of knowledge in the field of antimicrobial chemotherapy. 
  • e-Bug - operated by Public Health England, is a free microbiology, hygiene and antibiotic educational resource for junior (9-11 years) and senior (12-15 years) school students, young adults (15-18 years) and community groups across Europe. 
  • European Centre for Disease Prevention and Control (ECDC) - A number of initiatives are taking place across Europe to spread the messages on the risks associated with inappropriate use of antibiotics and how to take antibiotics responsibly.
  • Health Education England (HEE) Antimicrobial Resistance -  The HEE antimicrobial resistance animation intends to assist prescribers when they are faced with somebody who incorrectly feels they should be prescribed an antibiotic. 
  • Medicines for Children - The Medicines for Children website provides information for parents and carers about giving medicines to children, written and reviewed by doctors, pharmacists, parents and carers.
  • Patient.info - This website has useful patient information leaflets about all minor illnesses and self management options.
  • RCGP Sepsis Toolkit - The Sepsis toolkit provides a collection of tools, knowledge, and current guidance to support the identifying and appropriate management of patients with sepsis. 
  • Scottish Antimicrobial Prescribing Group (SAPG) - SAPG is a national clinical multi-disciplinary forum and its primary objective is to co-ordinate and deliver a national framework for antimicrobial stewardship to enhance the quality of antimicrobial prescribing and management in Scotland. 
  • Treat yourself better - The treat yourself better website has a symptom checker for cold and flu as well as the message that antibiotics do not work these symptoms.
  • World Antibiotic Awareness Week (WAAW) and European Antibiotic Awareness Day (EAAD) - WAAW/EAAD  takes place during November each year and aims to increase awareness of global antibiotic resistance and to encourage best practices among the general public, health workers and policy makers to avoid the further emergence and spread of antibiotic resistance. 

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