Medical Advisor

  • International Office

Medical Advisor

Job description

Title: Medical Advisor

Project: Revision of pathogen-specific antibiotic protocols for MSF
Duration:  9 months consultancy or 9 months contract    

Reporting to: Leader ABR Task Force

Deadline for applications: 31st May 2018                    


MSF INTERNATIONAL

Médecins Sans Frontières (MSF) is an international, independent, medical humanitarian organisation that delivers emergency aid to people affected by armed conflict, epidemics, healthcare exclusion and natural disasters. MSF offers assistance to people based only on need and irrespective of race, religion, gender or political affiliation.
MSF International is the legal entity that binds MSF’s 21 sections, 24 associations and other offices together. Based in Geneva, MSF International provides coordination, information and support to the MSF movement, and implements international projects and initiatives as requested.


POSITION BACKGROUND

As one of the pillars identified to address antibiotic resistance, Antibiotic Stewardship encompasses the rational use of antibiotics – specifically, the right antibiotic given for the right diagnosis, at the right dose, for the right duration, with de-escalation of broad-escalation of spectrum agents if and when possible.

Increasing numbers of projects within MSF are improving their access to microbiology.  Existing MSF protocols for targeted pathogen-specific antibiotic prescription are outdated and need revision.  These protocols are frequently adapted and re-written in an ad hoc, non-peer reviewed manner in many fields. In order to inform best practice for the field, there is a clear need to consolidate and revise existing antibiotic prescription protocols.  This is a necessary step to ensure not only rational use of broad-spectrum antibiotics - which will be used with increasing frequency as ABR rates increase – but, importantly, to inform clinical practice to optimize patient outcomes and minimize toxicity associated with inappropriate antibiotic choice.   


PLACE IN THE ORGANISATION

The position reports to the leader of the ABR task force.


OBJECTIVES OF THE POSITION

To develop a pathogen-based treatment protocol for projects with access to microbiology, focusing on sepsis, osteomyelitis, UTI and CNS infections, particularly in burns patients and those with renal impairment.  The protocols should also include the basics on ATB use including dosing, dose adjustments for particular cases (including children, patients with burns), de-escalation, etc.


MAIN RESPONSIBILITIES

Revision of pathogen-specific antibiotic protocols (including treatment of MDR pathogens):

  • Collate all existing MSF antibiotic prescription protocols from 5 sections
  • Revise/update protocols for (1) bone infections; (2) blood stream infections; (3) CNS infections; (4) UTI; (5) antibiotics in malnutrition; (6) surgical prophylaxis.
  • Include basics about antibiotic class and spectrum of activity •    Include adult and pediatric dosing
  • Dose adjustments in burns sepsis
  • Dose adjustments in renal impairment
  • Specific operational requirements for use of the antibiotic(s) (level of staff, need for specific microbiology expertise, intensive patient surveillance etc.)
  • Liase with key internal MSF stakeholders for clarification/review of document (AS sub-group of TF; leaders of relevant WG – eg. Surgical working group, PWG, malnutrition referent(s) etc.)
  • Liase with key external experts for technical review

WORKPLAN:

  1. Collate existing MSF antibiotic protocols from 5 OCs including surgical prophylaxis protocol
  2. Group into common clinical syndromes for which microbiology is increasingly utilized in MSF – including osteomyelitis, bloodstream infections, urinary tract infections, CNS infections
  3. Literature review and update of antibiotic treatment based on bacterial pathogen and site of infection, including evidence-based treatment recommendations for commonly seen multi-drug resistant bacterial infections (eg. ESBL infections, MRSA, CRE, XDR-gram negatives)
  4. Include dosing as listed above
  5. Collate into single document with brief introduction to antibiotic class and spectrum of activity
  6. Submit for internal review from Antibiotic Stewardship sub-group of Task Force and other relevant MSF WG – Surgical WG and Pediatric Working Group
  7. Submit for external review
  8. Incorporation of feedback and submission of draft for submission to DirMeds by end of 9-month contract
  9. There is a need to foresee how the DirMed recommendations will be integrated

PROFILE REQUIREMENTS

Professional training

  • Medical doctor with infectious disease specialisation and implementation of AS activities or with relevant experience in clinical microbiology.

Work experience

  • Relevant experience in stewardship activities
  • Protocols writing experience
  • At least 1 year working experience in resource-limited settings with MSF or an equivalent organization 

Requirements

  • Excellent networking and communication skills
  • Results and quality oriented
  • Proven ability of report & guidelines writing in English also for non-native English speakers
  • Computer literacy: Microsoft office is essential
  • Fluent in English (reading and writing); French is an asset