Summary

  • Health professionals play a key role in educating vulnerable and homeless patients on infection prevention, when and how to use antimicrobials.
  • Health professionals have developed a range of innovations to explain information to patients, using images, training workshops, self-care programmes and technology.
  • Informal evidence here suggests homeless patients are less likely to request antimicrobials than the housed population, though more data is needed.
  • Homeless patients are likely to be a higher needs group for antimicrobials, given their risks of serious infection.
  • Homeless patients often present when they have already reached a point of critical ill health. Infections could be more effectively managed without antimicrobials, if medical professionals had earlier contact with the patient.
  • Health professionals report poor adherence to finishing courses of treatment, and potentially dangerous second hand antimicrobial use in homeless (particularly drug-misusing) patients.
  • The living conditions of patients (in squats, sleeping rough or in hostels), and those misusing substances, present challenges to infection prevention.
  • Collaborations of local health professionals can help to solve problems such as how to improve the use of antimicrobials by those with an alcohol addiction.
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