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GPs defy flucloxacillin warnings

GP prescribing of flucloxacillin for skin conditions has increased despite warnings over the risk of serious liver reactions and rising antibiotic resistance, a new analysis reveals.

A research team from the RCGP found the number of flucloxacillin prescriptions for skin problems rose between 1999 and 2005, despite a slight drop in skin infections.

Experts in antibiotic prescribing warned GPs against complacency in their use of the drugs and advised they should think twice before prescribing flucloxacillin.

The new study, published in July's British Journal of General Practice, examined population surveillance data and national prescribing figures, and found flucloxacillin prescriptions rose from 2.7m in 1999 to 3.3m in 2005.

The number of skin infections in adults fell by 0.5% a year over the same period.

Study leader Dr Douglas Fleming, director of the RCGP Birmingham research unit, warned: 'GPs should not become complacent about antibiotic prescribing. This analysis supports the view that doctors have increased their likelihood of prescribing flucloxacillin capsules to adults.'

Dr Ian Williamson, a GP in Southampton and a researcher on antibiotic use at the University of Southampton, said GPs tended to prescribe flucloxa-cillin for skin infections because of worries about complications, such as leg ulcers in the elderly.

He added: 'Most infections will settle down and don't need treatment, so it is sensible to think should we be prescribing for this skin problem?'

But Dr Chaand Nagpaul, a member of the GPC prescribing subcommittee, dismissed accusations that GPs were overprescribing flucloxacillin: 'GPs have a duty to treat the clinical condition presented before them. The only way to reduce this rate would be to not treat some skin infections.'

He added: 'GPs are now seeing patients who would have previously been seen in hospital.'The UK drug regulator was criticised two years ago for failing to provide sufficient warnings to GPs on the potential dangers of flucloxacillin.

Writing in the British Journal of Clinical Pharmacology, researchers said the UK lagged behind the US and Australia in issuing strict warnings over the risk of fatal liver reactions.

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