NICE Publish New Antibiotics Guidlelines

Healthcare professionals should be discouraged from over-prescribing antibiotics, as overuse gives resistant bacteria a greater chance to survive and spread.

The National Institute for Health and Care Excellence (NICE) said that the problem of antibiotic resistance is compounded by the fact that the discovery of new antibiotics is at an all-time low.

NICE said that despite guidance that prescribing rates of antibiotics should be reduced, 9 out of 10 GPs feel pressured to prescribe antibiotics, and 97 per cent of patients who ask for antibiotics are prescribed them.

The first NICE guideline to address the issue recommends that GPs, nurses, pharmacists and dentists promote and monitor the sensible use of antimicrobials – a group of medicines that includes antibiotics.

If successfully implemented, NICE's latest guidance could help to reduce antibiotic prescribing by 25 per cent - accounting for around 10 million antibiotic prescriptions.

The guideline recommends setting up multidisciplinary antimicrobial stewardship teams working across all care settings. These teams should be able to review prescribing and resistance data frequently and feed this information back to prescribers.

They should also be able to work with prescribers to understand the reasons for very high, increasing or very low volumes of antimicrobial prescribing as well as provide feedback and assistance to those who prescribe antimicrobials outside of local guidelines where this is not justified.

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, said: "Antibiotics are prescribed in circumstances when they are unlikely to do the patient much good. Knowledge amongst GPs is well established that many patients with early or benign infections do not require and will not benefit from antibiotics. The vast majority of GPs will tell patients that.

"I don't think there is a lot of bad practice in general practice but it is clear that the reduction in antibiotic prescribing that we expected to see when our 2007 guideline on upper respiratory tract infections was published has not happened.

"The rise in inappropriate prescribing comes in the face of successive attempts by NICE and by government to reduce it that simply haven't worked. Some of it is about the pressure put on GPs. Despite that pressure, prescribing an antibiotic when you know it's unlikely to do the patient much good is not good practice.

"It's not just prescribers who should be questioned about their attitudes and beliefs about antibiotics."

(MH/LM)