GPs urged to hand out fewer antibiotic drugs

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Doctors should step in if they believe colleagues are prescribing antibiotics unnecessarily to help tackle the problem of rising drug-resistant infections, new draft guidelines say today.

GPs should also take time to explain to their patients the reasons why antibiotics might not be the best option, proposals from the National Institute for Health and Care Excellence (Nice) add.

Health chiefs are also urging patients not to put pressure on doctors to prescribe antibiotics when they do not need them.

The draft guidance aims to ensure that antimicrobial medicines such as antibiotics continue to be effective in treating infections as the more they are used, the more resistant they become.

In December, a report said unless action is taken, resistant bugs could be claiming at least an extra 10 million lives a year by 2050 - more than the number of people who currently die from cancer.

Prescriptions for antibiotics have been increasing steadily. Doctors have been criticised for prescribing them too readily. In 2013-14, 41.6 million prescriptions were issued at a cost of £192m to the NHS.

Alastair Hay, professor of primary care and chairman of the committee which devised the guidance, said: “The more we use antibiotics, the less effective they become as diseases evolve and become resistant to existing antimicrobial medicines. Resistance to all antimicrobials is increasing and, combined with a lack of new antimicrobial medicines, there is a heightened risk in the future that we may not be able to treat infections effectively.”

Antimicrobial medicines have been the mainstay of treating infections for more than 60 years, but very few new drugs have been developed over the past three decades, meaning existing antibiotics are being used to treat an ever greater variety of diseases.

Prof Mark Baker, director of the Centre for Clinical Practice at Nice, said: “This draft guidance recognises that we need to encourage an open and transparent culture that allows health professionals to question antimicrobial prescribing practices of colleagues when these are not in line with local and national guidelines and no reason is documented.

“But it’s not just prescribers who should be questioned about their attitudes and beliefs about antibiotics. It’s often patients themselves who, because they don’t understand that their condition will clear up by itself, or that perhaps antibiotics aren’t effective in treating it, may put pressure on their doctor to prescribe an antibiotic.”

He cited previous studies that found nine out of 10 GPs feel pressured to prescribe antibiotics, while 97 per cent of patients who ask for antibiotics are given them.