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EU GPs to be made exempt from UK rules

Plans to sell the first broad-spectrum antibiotic over the counter have been condemned as a backward step in the drive against antimicrobial resistance and a threat to life-saving treatments.

Pulse has learned that pharmaceutical company Aventis Pasteur has applied to the Medicines and Healthcare Products Regulatory Agency (MHRA) for a licence to allow pharmacists to sell chloramphenicol without a prescription.

The Government has made clear it would back any move to change the status of broad-spectrum antibiotics for eye infections from prescription only to pharmacy status, but experts believe the move could be the 'thin end of the wedge'.

And fears have been raised that chloramphenicol's effectiveness as a 'last resort treatment for life-threatening illness' such as typhoid, when used systemically, could be undermined by overuse.

The MHRA, believed to be considering 17 other drugs for a switch to OTC status, will decide next spring whether the drug should be the first antibacterial to be sold without a prescription.

But Government adviser Dr Douglas Fleming, a GP and member of the Specialist Advisory Committee on Antimicrobial Resistance, said he feared the move might 'establish a precedent'.

'As a general principle it's wiser to keep the limitation on antibiotics being prescribed by doctors,' he said.

Professor Hugh McGavock, visiting professor in prescribing science at the University of

Ulster and a former member

of the Committee on Safety of Medicines, warned antibiotic resistance rates in Spain and Italy, where some antibiotics are available over the counter, were double those in the UK.

He added that if an eye condition warranted the use of chloramphenicol it should be examined by a doctor who could differentiate viral and bacterial conjunctivitis.

GPC prescribing sub-committee chair Dr Peter Fellows said the GPC did not want antibiotics available OTC. He said he avoided prescribing chloramphenicol because of the known risk of local allergic reactions and reported bone marrow problems.

Other antibiotics on the joint Royal Pharmaceutical Society-MHRA wish list for OTC status include topical tetracycline and erythromycin for mild to moderate acne.

By Rob Finch

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