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7 November 2011
The Department of Health (DH) has published information to support European Antibiotics Awareness Day, which is on the 18th of November 2011. The aim of this annual event is to tackle the rise in antibiotic resistance and encourage responsible use of antibiotics. Support materials have been produced for both hospital and primary care settings and can be downloaded from the DH website.
Action
Prescribers and prescribing managers should consider using the support materials to promote the appropriate use of antibiotics. Healthcare professionals should follow NICE guidance on respiratory tract infections and/or local guidance based on advice from the Health Protection Agency (HPA).
The HPA advises that an antibiotic should be used only when there is likely to be a clear clinical benefit and, broad spectrum antibiotics (which include quinolones and cephalosporins) should be avoided where a narrow spectrum agent is indicated. Generally, prescribing for viral or mild, self-limiting infections such as coughs and colds is unlikely to improve the course of the illness, puts patients at risk of unnecessary adverse reactions (e.g. vomiting, diarrhoea, rash, fungal infection) and encourages further consultations.
NICE recommends that antibiotics should be offered immediately, with or without further appropriate investigation or management, in certain cases. For example, if the patient is likely to have a serious bacterial infection, or is at risk of suffering a prolonged or severe illness or complications, if he/she is systemically unwell or has pre-existing co-morbidities such as heart or lung disease. However, for many patients providing reassurance that the symptoms will resolve without antibiotic treatment and the use of watchful waiting or a delayed prescription may be more appropriate.
The NPC has produced resources to support the QIPP initiative, based on the document, Key therapeutic topics – medicines management options for local consideration. These include a set of slides with supporting notes and a recorded commentary to help clarify the key issues around antibiotic prescribing, especially quinolones and cephalosporins.
Why is the responsible use of antibiotics important?
As the DH letter says, the number of infections due to antibiotic-resistant bacteria is growing globally and is related to the overuse of antibiotics and inappropriate prescribing. Recently there have been decreases in MRSA and Clostridium difficile.However, infections are still a major threat to public health with many examples of recent media attention to this subject. While resistance to antibiotics is inevitable, prudent prescribing can help slow the development of resistance.
What support materials are available?
The support materials include factsheets aimed at prescribers and prescribing managers detailing the main issues surrounding antibiotic resistance, and a slide presentation which can be used for staff and medical students in hospital training. Resources for patients include leaflets, posters and non-prescription pads, which can be printed and given to patients as a aide memoire as to why antibiotics have not been prescribed at a consultation. In addition the Royal College of General Practitioners has produced a booklet ‘When should I worry’ for use in primary care consultations with parents about the management of respiratory tract infections in children. There are also short videos for use in patient waiting areas to remind patients to ‘Take care, not antibiotics’.
Further information on common infections can be found on NHS Evidence and in the common infections e-learning section of the NPC website. The NPC e-learning resources include two patient decision aids on common infections, which may be helpful when discussing the benefits and risks of using antibiotics with patients.
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