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RAMP - Resident Antimicrobial Management Plan

Clinically validated tool to aid appropriate provision of antibiotics within care homes

RAMP is a tool to help reduce unnecessary prescription of antimicrobials in care homes.

  • Validated in a prospective cluster randomised controlled study of 1628 care home residents

  • Demonstrated to reduce total antibiotic consumption in care home setting

  • Simple form completed by nursing staff before, during and after course of antimicrobial treatment


Licences for this tool are available either for on an annual or short-term evaluation basis. Please email to enquire.


Multi-resistant strains of pathogenic microbes are emerging at an alarming rate in healthcare systems throughout the world including the NHS, prompting the issue of antimicrobial resistance to be added to the government’s National Security Risk Register. A well recognised contributor to the development of antimicrobial resistance is over-prescription of broad spectrum antimicrobials. Therefore, there is an urgent need to curb unnecessary ‘just in case’ prescription of antimicrobials.

The Resident Antimicrobial Management Plan (RAMP) tool is designed for use in care homes without on-site doctors. RAMP contains good practice points to follow and assists nurses to alert a doctor if a resident requires medical review. RAMP also provides a standardised framework for attending doctors to rely upon when deciding whether a resident doesn’t or no longer has an infection and therefore does not require antimicrobials.

The RAMP tool is a form that is completed by nursing staff before and after the commencement of antimicrobial treatment that establishes a record of the initial infectious indication, antimicrobial prescription and patient response following treatment. The RAMP tool has been validated within a prospective cluster randomized controlled study of 1628 care home residents. Use of RAMP led to significant reductions in the total antibiotic consumption and improved prescription of antimicrobials that fully met clinical definitions for infection.

RAMP was developed by:

  • Dr Gopal Rao (Consultant Microbiologist/Lead Clinician Infection Control & Head of Department, London North West Healthcare NHS Trust)


  • Liz Fleet (Specialist Clinical Pharamacist, London North West Healthcare NHS Trust)


In summary, RAMP is a validated antimicrobial stewardship tool capable of reducing excessive antimicrobial prescription and improving clinical practice within care homes, potentially leading to a reduction in antimicrobial resistance and infection related healthcare costs, ultimately benefiting us all.


Reference: Fleet et al. (2014) Impact of implementation of a novel antimicrobial stewardship tool on antibiotic use in nursing homes: a prospective cluster randomized control pilot study, Journal of Antimicrobial Chemotherapy 69(8): 2265-73

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