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GPs cleared in pneumonia antibiotic prescribing row

GP curbs on antibiotic prescribing are not to blame for an increase in pneumonia deaths, a Government investigation has concluded.

Members of the specialist advisory committee on antimicrobial resistance (SACAR) have decided that evidence for the suggested link is too weak to justify any easing of the high-profile campaign to cut antibiotic use.

The inquiry was launched after a study from researchers at the University of Aberdeen found pneumonia deaths had surged from 20.4 per 100,000 to 30.7 per 100,000 over a four-year period when GP prescriptions for lower respiratory tract infections fell by 30 per cent.

Dr Douglas Fleming, director of the RCGP's Birmingham research unit and a member of SACAR, told Pulse the committee had written to the Journal of Respiratory Medicine ­ which published the study in December ­ to point out various flaws in its methodology.

'There have been more deaths attributed to pneumonia,' said Dr Fleming, 'but the link to antibiotic prescribing is very weak.'

More evidence to prove cause and effect, particularly with respect to antibiotic use in elderly people, was needed, he said.

'Clearly if you have got pneumonia you have to have an antibacterial but the vast majority of respiratory infections are viral and don't give rise to bacterial pneumonia,' he said.

Meanwhile, a study presented at the spring meeting of the Royal College of Paediatrics and Child Health in York last week found that calls for GPs to reduce antibiotic prescribing have led to major reductions in the number of antibacterial prescriptions given to children.

Researchers from St

George's Hospital in London and the Prescription Pricing Authority found between 1993 and 2002 antibiotic

prescriptions for 0-14-year-olds fell by 50 per cent ­

from 12.4 million to 6.5

million.

Dr Helen Kendall, an official at the authority, said the most striking reductions were for ampicillin and co-trimoxazole (95 per cent).

There were also marked reductions in the three most common antibiotics ­ amoxicillin (42 per cent), erythro-mycin (62 per cent) and phenoxymethylpenicillin (47 per cent).

By Emma Wilkinson

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