The National Institute for Health and Care Excellence (NICE) has issued new guidance to reduce over-prescribing of antibiotics. It is estimated that 10 million prescriptions per year may be inappropriate. There is some debate whether regulators should confront persistent over-prescribing doctors.
Gallagher, J. (2015). Call to punish GPs over antibiotics. London: BBC Health News, August 18th 2015.
Antimicrobial Stewardship: Confronting the Challenge of Antimicrobial Resistance
The NICE guideline (and associated NICE Pathways) covers the effective use of antimicrobials in children, young people and adults. The aim is to change prescribing practice, thereby slowing the emergence of antimicrobial resistance and ensuring antimicrobials remain effective as treatments for infection.
Antimicrobial stewardship: systems and processes for effective antimicrobial medicine use: guidance (NG15). London: National Institute for Health and Care Excellence, August 18th 2015.
NHS England, Health Education England and Public Health England have issued a joint National Patient Safety Alert to all NHS care providers in England, highlighting the challenge of antimicrobial resistance (AMR) and the need for better antimicrobial stewardship.
Two toolkits to support local antimicrobial stewardship initiatives include the TARGET (Treat Antibiotics Responsibly, Guidance, Education, Tools) and the Antimicrobial Stewardship: Start Smart then Focus toolkits.
Patient safety alert – addressing antimicrobial resistance through implementation of an antimicrobial stewardship programme. London: NHS England, August 18th 2015.
This relates to:
Patient Safety Alert – Stage 2 Resources: addressing antimicrobial resistance through implementation of an antimicrobial stewardship programme. London: NHS England, August 18th 2015. Alert reference number: NHS/PSA/Re/2015/007.
Further BBC News coverage:
Walsh, F. (2014). Why antibiotics are precious. London: BBC Health News, August 18th 2015.
Walsh, F. (2014). Call for $2bn global antibiotic research fund. London: BBC Health News, May 14th 2015.
Gallagher, J. (2015). Antibiotics: Are we reckless drivers when it comes to drugs? London: BBC Health News, August 18th 2015.
Possibly also of interest, regarding NICE guidance on antimicrobial stewardship:
Public Health England, Health Protection Report: HPR. Volume 9(29), August 21st 2015.
Glimmers of hope on the new drugs discovery front?
Gallagher, J. (2015). Antibiotics: US discovery labelled ‘game-changer’ for medicine. London: BBC Health News, January 7th 2015.
Turning the Tide?
A 2016 Public Health England report found antibiotic prescribing had reduced significantly across the healthcare system; with, 2.2 million fewer antibiotic prescriptions (6% of all prescriptions) dispensed in the community in 2015 compared to 2014.
English surveillance programme for antimicrobial utilisation and resistance (ESPAUR): Report 2016. London: Public Health England, November 2016. PHE Publications Gateway No. 2016450.
Obesity and Dosing Recommendations for Different Classes of Antibiotics
The following Q&A was updated based on evidence in 2016, and summarises the available evidence for several classes of antibiotics.
How should antibiotics be dosed in obesity? Specialist Pharmacy Service / Scottish Antimicrobial Prescribing Group (SAPG), March 1st 2017 / July 27th 2017.
An Intriguing Behind the Scenes Debate on Best Advice to the Public
The official advice to the public remains unchanged, at present.
Mundasad, S. (2017). Should you finish a course of antibiotics? London: BBC Health News, July 27th 2017.
This relates to:
Llewelyn, MJ. Fitzpatrick, JM. [and] Darwin, E. [et al] (2017). The antibiotic course has had its day. BMJ. July 26th 2017; 358: j3418.
Also of interest:
Elias, C. Moja, L. [and] Mertz, D. [et al] (2017). Guideline recommendations and antimicrobial resistance: the need for a change. BMJ Open. July 26th 2017; 7(7): e016264.