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GP guidance on MRSA in pipeline

New guidelines are being drafted to help GPs diagnose and treat patients with community-acquired MRSA infections, Pulse can exclusively reveal.

The guidance is intended to address the fact that GPs are now being required to manage MRSA infections with ‘increasing frequency'.

GPs will be encouraged to do more investigations for cases of suspected infections, initiate antibiotic therapy and refer patients to hospital where appropriate.

The move comes merely two months after Pulse revealed the Department of Health had launched a ‘robust and comprehensive' surveillance system to monitor MRSA infections in primary care.

Research had shown that prescriptions for community-acquired staphylococcus infections rose by more than 90% in ten years, with a comparable increase in hospital admissions.

The consultation period on the draft guidance, produced jointly by the Health Protection Agency and the British Society for Antimicrobial Chemotherapy (BSAC), ended in November and the guide-lines will be published officially in February and available on the HPA website.

Professor Dilip Nathwani, who chaired the guideline group, told Pulse that new community acquired strains of MRSA were emerging in characteristically young patients who have had no contact with hospitals.

‘We need to raise awareness of these strains but also give GPs and other primary care health professionals the tools to recognise and distinguish it from hospital-acquired MRSA.'

Prof Nathwani, consultant physician in infectious disease at the Ninewell's hospital in Dundee, added: ‘It's important that we apply what we have learned from hospital-acquired MRSA, what we don't want is to make the same mistakes again.

‘We're trying to encourage GPs to take more investigations then they did in the past.'

Dr Matthew Dryden, a consultant in microbiology at the Royal Hampshire County Hospital and a member of the BSAC, said:

‘MRSA is not going to go away. Also there's been a huge focus by the Department of Health to control it in hospitals, but there are more and more people out in the community, particularly the elderly and those with chronic diseases, who are exposed.'

‘GPs by and large have not encountered it but it is becoming commoner and we felt it was important that they had guidelines on what to do and inform them about the new antibiotics that are available.'

Handwashing CA-MRSA: steps to take

CA-MRSA: steps to take

1. Is the infection MSSA or MRSA?
2. If MRSA is sus-pected, is it likely to be CA-MRSA or HA-MRSA?
3. Should further microbiological assess-ment/investigation be undertaken and, if so, what?
4. What is the severity of illness?
5. Does empirical antibiotic therapy (or definitive therapy if microbiology is available) need to be started?
6. Does adjunct therapy (e.g surgical drainage) need to be considered?
7. Does the patient need to be admitted to hospital?

Source: BSAC

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