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‘Any system that helps GPs to reflect on their level of antibiotic prescribing is helpful’

Dr Tessa Lewis, GP and vice chair of the guideline development group, speaks to Pulse about the new NICE guidelines on antimicrobial stewardship

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Readers' comments (26)

  • John Glasspool

    A very quick trawl of the net shows the MASSIVE use of antibiotics in farming still, for "treatment, prophylaxis and growth-promotion". A GPs possibly "inappropriate" use of 5g of Amoxicillin pales into insignificance.

    Also note that in much of the world, INCLUDING SPAIN, you can buy antibiotics OTC.

    Sort that out first, NICE.

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  • What about

    'Any system that helps NICE to reflect on their level of unrealistic guideline is helpful'

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  • Where are the posters leaflets and TV adverts???? OH - none! Clearly NOT a government issue. Go tell the patient electorate to 'reflect'.

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  • Any system that tries to force change using threats will be met with resentment and undermine the credibility of those responsible for it.

    Why don't you explain the problem, suggest a solution and ask us nicely?

    With every day that passes I feel more and more like the victim of an abusive relationship.

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  • Do you think your constant bashing of GP's is going to help the recruitment crisis? The media, the government, NICE should all be ASHAMED of themselves for attacking GP's. Mass exodus is happening already. Well done!

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  • Only doctors need to reflect. The rest of the public, especially the ivory towers lot can be as unrealistic about anything, say what they want and not have to worry about it. Go forth and multiply of the whole lot of you.

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  • If certain GPs tend to attract patients with complex multiple morbidities who have higher risks of complications if not treated with antibiotics - will these GPs be punished for being outliers? It hardly seems fair.

    Leave doctors to make decisions with the individual patients they see.

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  • John Glasspool

    Sent today to NICE

    Dear Sir/Madam,

    Well, I guess it is that time of year again when you start to castigate GPs for antibiotic use, despite the fact that it can be clinically impossible to tell the difference between viral an bacterial illness much of the time.

    Are you aware that in most of the world, antibiotics are still added to animal feeds, by the tonne, for "prophylaxis and growth promotion"? What have GPs to do with this?

    Even in the EU, Spain for example, one can buy antibiotics OTC without any need for explanation at all. I didn't believe this, so tried it six months ago in A Corunna. I bought a packet of Ciprofloxacin without being even asked why I needed it.

    In much of the world one can buy almost anything, short of Diamorphine, in a pharmacy.

    Veterinary use of antibiotics seems to have a very low threshold here in the UK.

    Yet, despite this, you have to bring out this pile of manure to steam in the sun again and again: that somehow GPs are responsible for all antimicrobial resistance.

    Yes, I am aware that there is large variance in antibiotic prescribing amongst GPs, but it pales into nothing when one considers the above.

    Why don't you look to these other areas before slagging off hard-pressed clinicians?


    John Glasspool​ BM FRCP FRCGP (Retired and very glad)​

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  • Dear All,
    Just remember what Rawlins said when he was chairman of NICE in response to a question; "when should GPs slavishly follow NICE guidance?". His answer - "never". Every decision is an individual one and the sanctity of the consultation room is paramount.
    just file this latest guidance alongside the used dressings.
    Regards
    Paul C

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  • @ 6:37
    Great until you get complaint/sued and the "expert witness" declares you haven't followed NICE guidelines to the letter.........

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