GPs to Rethink Number of Antibiotics Prescribed
There are 42 million prescriptions written each year in England, around 10 million of which are not needed or incorrect.
There is talk amongst leading health figures that the world of modern medicine is facing an ‘antibiotic apocalypse’. This ‘apocalypse’ could result in infections and diseases we have been immune to for years killing once more. This is in part due to the apparent unnecessary prescription of antibiotics for respiratory infections, including the common cold and sore throats, which has led to an increase in resistance.
According to the National Institute for Healthcare and Excellence, if past guidelines on this particular type of infection were to be followed, there would be a decrease in prescriptions of 22%.
Professor Mark Baker, director of ‘Centre of Clinical Practice’ at the National Institute for Healthcare and Excellence (NICE) has said:
“People who overuse antibiotics are creating a problem for patients with life-threatening infections…
“We are proposing that evidence is collected so the finger can be pointed at people who are a soft touch.”
According to Professor Baker, overprescribing is a “really hazardous practice” that can have negative effects on patients. He has also expressed his concern over the number of individuals that are increasingly becoming ‘addicted’ to the thought of receiving antibiotics.
There is enormous pressure on GPs from patients to receive antibiotics, with 97% of those that ask for drugs receiving them. Baker has called for a change in practice and for officials to regulate those GPs that are overprescribing. ‘If necessary’, he believes that GPs should be referred to the General Medical Council for overprescribing.
NICE – New Set of Guidelines for NHS
NICE have since devised a new set of guidelines that aim to lower the number of antibiotic prescriptions handed out per year in England by the NHS by 25%. They will provide GPs with help in making decisions, such as when to refuse to write a prescription and when it would be inadvisable to offer antibiotics.
However, not all agree with this method of thinking.
Dr Tim Ballard, of the Royal College of GPs, has advised that the focus here should be on a ‘societal change’ rather than doctors themselves. He said:
“Any suggestion that hard-pressed GPs – who are already trying to do their jobs in increasingly difficult circumstances – will be reported to the regulator is counter-productive and unhelpful.”
Change of Practice
Chief executive of the General Medical Council, Niall Dickinson, has suggested that annual appraisals should include the revision of doctor’s prescribing habits. He said:
“Doctors can, and do, face sanctions for mis-prescribing.” But the message is “more about changing the norms of practice generally than pursuing individual doctors”.
Other suggestions to avoid over prescribing include the implementation of ‘antimicrobial stewards’ to detect high levels of prescribing and also the use of ‘delayed prescribing’. The latter would mean that a patient’s condition and symptoms would have to deteriorate in order to use the prescription.
Guidelines relating to educating the public are said to be released by NICE next year.
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