When microbiologist Robin Pavillard reported in April 1977 that 25 per cent of Staphylococcus aureus infections at The Royal Melbourne Hospital were resistant to many antibiotics, clinical pharmacologist John Shaw, chair of the hospital’s Pharmaceutical Advisory Committee recommended that the major hospitals be advised of the situation. He also suggested that a meeting be called to address the problem and formulate some antibiotic usage guidelines. A draft of these guidelines was prepared in July by John Shaw and microbiologist Ken Harvey. It was decided the guidelines should be disease oriented; cover only the most important areas of antibiotic use; provide clear, simple instructions including average dosage schedules; recommend older, cheaper, and narrower spectrum drugs unless real considerations of safety or efficacy demanded otherwise; and be produced in a convenient format, able to fit into a white coat pocket.
Representatives from ten other major hospitals in Melbourne were invited to a meeting on 4 August 1977 at The Royal Melbourne Hospital. This in itself was a significant event, as it brokered collaboration between major hospitals. Organised by Pharmaceutical Advisory Committee secretary Neil Naismith and chairman John Shaw, 32 microbiologists and/or pharmaceutical committee representatives attended from The Alfred Hospital, Austin Hospital, Box Hill and District Hospital, Preston and Northcote Community Hospital, Prince Henry’s Hospital, The Royal Children’s Hospital, The Royal Women’s Hospital, St Vincent’s Hospital, The Queen Victoria Memorial Hospital, The Royal Melbourne Hospital and Western General Hospital.
It was agreed that guidelines for sensible prescribing would be a major advance and represented the best chance for a long-term solution.
A small working party was formed to consider in detail the draft of the guidelines, and to prepare a final version. The team of six included John Shaw and Ken Harvey from The Royal Melbourne Hospital, John Spicer from The Alfred Hospital, microbiologist Fred Tosolini and pharmacist Barry Parsons, both from the Austin Hospital, and microbiologist Dr Bryan Stratford from St Vincent’s Hospital. A draft version of the text was ready in September and sent to all 11 hospitals for discussion. The first edition was quickly and enthusiastically finalised at another meeting on 8 December 1977.
