The Pharmaceutical Journal
Vol 279 No 7462 p90
28 July 2007

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Antibiotic prescribing guidance still ignored by GPs

GPs are still prescribing antibiotics in over 40 per cent of cases of upper respiratory tract infections, and in over 60 per cent of cases of sore throat, otitis media and sinusitis, according to an analysis of the UK's General Practice Research Database. Such prescribing does not comply with national guidelines.

But while levels of prescribing are high for these conditions, the analysis reveals that the antibiotics most widely used in primary care are usually those recommended as first-line treatments.

The analysis forms part of a series of articles relating to the work of the Specialist Advisory Committee on Antimicrobial Resistance (SACAR), a government advisory body, published this week in a supplement to the Journal of Antimicrobial Chemotherapy (2007;60:Suppl 1).

To rein in the impact of poor prescribing on antimicrobial resistance, significant educational change is required, say the authors of a report from SACAR’s professional educational subgroup. They raise concerns about mechanisms that allow the wider supply of antimicrobials, such as patient group directions, medicine reclassification and increasing numbers of prescribers.

“Instead of focusing on which health professional writes the prescription, we need to develop a coherent, multidisciplinary approach to the entire process from patients presenting with a problem, through diagnosis, prescribing, dispensing and administration of an antimicrobial (when necessary) to assessment of the patient’s outcome,” the authors say.

The value of antimicrobial pharmacists is highlighted in several of the papers, including one by Jonathan Cooke, chairman of SACAR’s prescribing subgroup and clinical director of pharmacy and medicines management, University Hospital of South Manchester.

SACAR, which was set up in 2001 to advise ministers and the chief medical officer on current and emerging problems in antimicrobial resistance, is to be replaced with a new body, the Advisory Committee on Antimicrobial Resistance and Associated Health Care Infections.