Enrique Castro
@castrocloud.bsky.social
Infection Control specialist, UKHSA. Lecturer in #planetaryhealth, UOC. #AntimicrobialStewardship. #HealthDiplomacy. #enfermera. #FNFScholar #NIHR70at70. Migrant (or ‘citizen of nowhere’). Cat butler. Sailor, soon. He/él. My views only, not employer’s.
If your AMS role vanished tomorrow… what would your ward, facility, health system lose?
And how would you prove it, in numbers, not just narratives?
Full reflection here: open.substack.com/pub/theamsnu...
#AMR #Nursing #Stewardship #HealthEconomics #AMS #IPC #PatientSafety
And how would you prove it, in numbers, not just narratives?
Full reflection here: open.substack.com/pub/theamsnu...
#AMR #Nursing #Stewardship #HealthEconomics #AMS #IPC #PatientSafety
December 1, 2025 at 7:24 PM
If your AMS role vanished tomorrow… what would your ward, facility, health system lose?
And how would you prove it, in numbers, not just narratives?
Full reflection here: open.substack.com/pub/theamsnu...
#AMR #Nursing #Stewardship #HealthEconomics #AMS #IPC #PatientSafety
And how would you prove it, in numbers, not just narratives?
Full reflection here: open.substack.com/pub/theamsnu...
#AMR #Nursing #Stewardship #HealthEconomics #AMS #IPC #PatientSafety
AMS programmes save money. But unless nursing contributions are made visible, they risk disappearing at budget time.
December 1, 2025 at 7:24 PM
AMS programmes save money. But unless nursing contributions are made visible, they risk disappearing at budget time.
From COM-B–based engagement tools to nursing-sensitive stewardship outcomes, we now have ways to show what nurses already do, and what their work is worth.
December 1, 2025 at 7:24 PM
From COM-B–based engagement tools to nursing-sensitive stewardship outcomes, we now have ways to show what nurses already do, and what their work is worth.
My new The AMS Nurse Substack post asks a simple question with big consequences:
If we don’t measure the value of AMS nursing, how can we argue for sustainable funding?
If we don’t measure the value of AMS nursing, how can we argue for sustainable funding?
December 1, 2025 at 7:24 PM
My new The AMS Nurse Substack post asks a simple question with big consequences:
If we don’t measure the value of AMS nursing, how can we argue for sustainable funding?
If we don’t measure the value of AMS nursing, how can we argue for sustainable funding?
We talk a lot about “empowering nurses” in stewardship, but not enough about securing the roles themselves.
December 1, 2025 at 7:24 PM
We talk a lot about “empowering nurses” in stewardship, but not enough about securing the roles themselves.
My post on The AMS Substack sits in that uneasy space between praise and permission, asking what real partnership in stewardship might look like, and what it costs to keep showing up when the system still doesn’t always listen.
open.substack.com/pub/theamsnu...
open.substack.com/pub/theamsnu...
Between Admiration and Authority: How Far Does Nursing Partnership in Antimicrobial Stewardship Really Go?
When the pharmacist calls for collaboration, but the system still resists it.
open.substack.com
November 12, 2025 at 3:00 PM
My post on The AMS Substack sits in that uneasy space between praise and permission, asking what real partnership in stewardship might look like, and what it costs to keep showing up when the system still doesn’t always listen.
open.substack.com/pub/theamsnu...
open.substack.com/pub/theamsnu...
Yet, in the quiet moments of practice, during the IV review that went unnoticed, or the hesitant suggestion that gets waved away, admiration starts to sound a little hollow.
November 12, 2025 at 3:00 PM
Yet, in the quiet moments of practice, during the IV review that went unnoticed, or the hesitant suggestion that gets waved away, admiration starts to sound a little hollow.
Epidemics test our values as much as our systems.
When fear rises, will we choose compassion or blame?
Our editorial argues for solidarity, because dignity is a public health intervention.
doi.org/10.1002/nop2...
When fear rises, will we choose compassion or blame?
Our editorial argues for solidarity, because dignity is a public health intervention.
doi.org/10.1002/nop2...
The Stigmatisation of Men Who Have Sex With Men in the Spread of Mpox: Are We Repeating the Mistakes of HIV?
The 2022 mpox outbreak disproportionately affected men who have sex with men (MSM), leading to targeted public health interventions. While data supported prioritising MSM, this focus risks reviving s...
doi.org
November 10, 2025 at 9:39 PM
Epidemics test our values as much as our systems.
When fear rises, will we choose compassion or blame?
Our editorial argues for solidarity, because dignity is a public health intervention.
doi.org/10.1002/nop2...
When fear rises, will we choose compassion or blame?
Our editorial argues for solidarity, because dignity is a public health intervention.
doi.org/10.1002/nop2...
Nurses are at the frontlines of inclusion. We listen, educate, advocate, often when others won’t.
In mpox, as in HIV, nursing leadership can rebuild trust and confront stigma.
In mpox, as in HIV, nursing leadership can rebuild trust and confront stigma.
November 10, 2025 at 9:39 PM
Nurses are at the frontlines of inclusion. We listen, educate, advocate, often when others won’t.
In mpox, as in HIV, nursing leadership can rebuild trust and confront stigma.
In mpox, as in HIV, nursing leadership can rebuild trust and confront stigma.
HIV taught us that solidarity and empowerment save lives.
Mpox reminds us that stigma still shapes outbreak response.
Let’s not repeat history, let’s rewrite it with empathy and evidence.
Mpox reminds us that stigma still shapes outbreak response.
Let’s not repeat history, let’s rewrite it with empathy and evidence.
November 10, 2025 at 9:39 PM
HIV taught us that solidarity and empowerment save lives.
Mpox reminds us that stigma still shapes outbreak response.
Let’s not repeat history, let’s rewrite it with empathy and evidence.
Mpox reminds us that stigma still shapes outbreak response.
Let’s not repeat history, let’s rewrite it with empathy and evidence.
Stigma doesn’t stop infection, but it fuels it.
When communities feel blamed, they disengage from prevention, testing, and care.
Public health language matters.
When communities feel blamed, they disengage from prevention, testing, and care.
Public health language matters.
November 10, 2025 at 9:39 PM
Stigma doesn’t stop infection, but it fuels it.
When communities feel blamed, they disengage from prevention, testing, and care.
Public health language matters.
When communities feel blamed, they disengage from prevention, testing, and care.
Public health language matters.
The 2022 mpox outbreak hit MSM communities hardest. But focusing only on risk groups risks repeating old narratives.
Epidemiology can’t justify stigma. Public health must protect people, not just populations.
Epidemiology can’t justify stigma. Public health must protect people, not just populations.
November 10, 2025 at 9:39 PM
The 2022 mpox outbreak hit MSM communities hardest. But focusing only on risk groups risks repeating old narratives.
Epidemiology can’t justify stigma. Public health must protect people, not just populations.
Epidemiology can’t justify stigma. Public health must protect people, not just populations.
My new The AMS Nurse reflection, written during #ESICM2025, asks what would change if we recognised critical-care nursing vigilance as leadership.
Read more theamsnurse.substack.com/p/in-the-cru...
Read more theamsnurse.substack.com/p/in-the-cru...
In the Crucible of Care: Why the Critical Care Nurse Is (another!) Unsung Hero of Antibiotic Stewardship
Reflections from the European intensive care frontlines of antimicrobial resistance
theamsnurse.substack.com
October 28, 2025 at 1:20 PM
My new The AMS Nurse reflection, written during #ESICM2025, asks what would change if we recognised critical-care nursing vigilance as leadership.
Read more theamsnurse.substack.com/p/in-the-cru...
Read more theamsnurse.substack.com/p/in-the-cru...
Two decades of research show the pattern: when nurses prompt, question, and advocate, antibiotic use falls … but hierarchy and workload still silence those voices.
October 28, 2025 at 1:20 PM
Two decades of research show the pattern: when nurses prompt, question, and advocate, antibiotic use falls … but hierarchy and workload still silence those voices.
ICU nurses see antibiotics started, hung, reviewed, and stopped.
They are the 24-hour sentinels of antimicrobial stewardship; yet still one of the most overlooked leaders in the room.
They are the 24-hour sentinels of antimicrobial stewardship; yet still one of the most overlooked leaders in the room.
October 28, 2025 at 1:20 PM
ICU nurses see antibiotics started, hung, reviewed, and stopped.
They are the 24-hour sentinels of antimicrobial stewardship; yet still one of the most overlooked leaders in the room.
They are the 24-hour sentinels of antimicrobial stewardship; yet still one of the most overlooked leaders in the room.
Looking ahead
Community health workers already save lives every day.
With the right systems, they can also protect the effectiveness of antibiotics for generations.
It’s time to see them as key agents of change in the work to prevent and address #AMR.
🔗 doi.org/10.1136/bmjg...
Community health workers already save lives every day.
With the right systems, they can also protect the effectiveness of antibiotics for generations.
It’s time to see them as key agents of change in the work to prevent and address #AMR.
🔗 doi.org/10.1136/bmjg...
Involvement of community health workers in antimicrobial stewardship interventions and programmes: a scoping review
Introduction Antimicrobial resistance (AMR) poses a global health threat, especially in low-income and middle-income countries. Community health workers (CHWs) are key actors in infection management a...
doi.org
October 27, 2025 at 9:54 AM
Looking ahead
Community health workers already save lives every day.
With the right systems, they can also protect the effectiveness of antibiotics for generations.
It’s time to see them as key agents of change in the work to prevent and address #AMR.
🔗 doi.org/10.1136/bmjg...
Community health workers already save lives every day.
With the right systems, they can also protect the effectiveness of antibiotics for generations.
It’s time to see them as key agents of change in the work to prevent and address #AMR.
🔗 doi.org/10.1136/bmjg...
Policy implications
Our review calls for CHWs to be formally integrated into national AMS policies.
They need clear scopes of practice, fair pay, and ongoing learning opportunities.
Investing in CHWs means investing in equity and resilience. #CommunityHealth
Our review calls for CHWs to be formally integrated into national AMS policies.
They need clear scopes of practice, fair pay, and ongoing learning opportunities.
Investing in CHWs means investing in equity and resilience. #CommunityHealth
October 27, 2025 at 9:54 AM
Policy implications
Our review calls for CHWs to be formally integrated into national AMS policies.
They need clear scopes of practice, fair pay, and ongoing learning opportunities.
Investing in CHWs means investing in equity and resilience. #CommunityHealth
Our review calls for CHWs to be formally integrated into national AMS policies.
They need clear scopes of practice, fair pay, and ongoing learning opportunities.
Investing in CHWs means investing in equity and resilience. #CommunityHealth
Training & Support
Training makes the difference.
Where CHWs had structured AMS education, supervision & feedback tools, outcomes improved—better adherence to guidelines, fewer unnecessary prescriptions.
Without that support, progress stalls. #AMR #Stewardship
Training makes the difference.
Where CHWs had structured AMS education, supervision & feedback tools, outcomes improved—better adherence to guidelines, fewer unnecessary prescriptions.
Without that support, progress stalls. #AMR #Stewardship
October 27, 2025 at 9:54 AM
Training & Support
Training makes the difference.
Where CHWs had structured AMS education, supervision & feedback tools, outcomes improved—better adherence to guidelines, fewer unnecessary prescriptions.
Without that support, progress stalls. #AMR #Stewardship
Training makes the difference.
Where CHWs had structured AMS education, supervision & feedback tools, outcomes improved—better adherence to guidelines, fewer unnecessary prescriptions.
Without that support, progress stalls. #AMR #Stewardship
What we found
Across 8 studies in Uganda, Tanzania, Zambia, Pakistan, Bangladesh & Kenya, CHWs helped prevent, detect & treat infections—often reducing inappropriate antibiotic use.
But their stewardship role is rarely formalised or supported. #GlobalHealth
Across 8 studies in Uganda, Tanzania, Zambia, Pakistan, Bangladesh & Kenya, CHWs helped prevent, detect & treat infections—often reducing inappropriate antibiotic use.
But their stewardship role is rarely formalised or supported. #GlobalHealth
October 27, 2025 at 9:54 AM
What we found
Across 8 studies in Uganda, Tanzania, Zambia, Pakistan, Bangladesh & Kenya, CHWs helped prevent, detect & treat infections—often reducing inappropriate antibiotic use.
But their stewardship role is rarely formalised or supported. #GlobalHealth
Across 8 studies in Uganda, Tanzania, Zambia, Pakistan, Bangladesh & Kenya, CHWs helped prevent, detect & treat infections—often reducing inappropriate antibiotic use.
But their stewardship role is rarely formalised or supported. #GlobalHealth
Why this matters
#AMR kills over 1.2 million people each year—mostly in low- and middle-income countries.
Yet those same health systems rely heavily on community health workers.
How can we harness their role in responsible antibiotic use? Our review explores just that.
#AMR kills over 1.2 million people each year—mostly in low- and middle-income countries.
Yet those same health systems rely heavily on community health workers.
How can we harness their role in responsible antibiotic use? Our review explores just that.
October 27, 2025 at 9:54 AM
Why this matters
#AMR kills over 1.2 million people each year—mostly in low- and middle-income countries.
Yet those same health systems rely heavily on community health workers.
How can we harness their role in responsible antibiotic use? Our review explores just that.
#AMR kills over 1.2 million people each year—mostly in low- and middle-income countries.
Yet those same health systems rely heavily on community health workers.
How can we harness their role in responsible antibiotic use? Our review explores just that.