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GPs handed key MRSA role

By Lilian Anekwe

GPs are to be drawn on to the frontline of the battle with MRSA with new guidance looking to drive an increase in the number of swabs conducted in patients with suspicious symptoms.

The draft guidance, obtained by Pulse, asks GPs to assess the likelihood of infection with community-acquired MRSA through close contacts and recommends empirical prescribing in some cases.

The move is the latest bid to stem soaring infection rates outside hospitals and has been prepared as a matter of urgency by the Health Protection Agency and the British Society for Antimicrobial Chemotherapy (BSAC).

It follows Pulse's revelation in October that the Department of Health was launching a primary care MRSA surveillance system, following a 90% rise in prescriptions for community-acquired staphylococcus infections in 10 years, with a comparable increase in hospital admissions.

GPs will be asked to send swabs for culture if there are recurrent furuncles or abscesses, if the patient has a history of infection or if there may have been spread within the family or from other close contacts.

The guidance presents GPs with three clinical scenarios and offers diagnostic and management advice (see box).

Professor Dilip Nathwani, chair of the guideline group and consultant physician in infectious disease at the Ninewell's Hospital in Dundee, told Pulse: ‘It's important we apply what we've learned from hospital-acquired MRSA - what we don't want is to make the same mistakes again.'

Dr Matthew Dryden, a consultant in microbiology at the Royal Hampshire County Hospital and a member of the BSAC, added: ‘It's becoming commoner and we felt it was important that GPs had guidelines on what to do and inform them about newer antibiotics.'

Dr Jonathan McClaren, a GP in Durham, worked on antibiotic prescribing policy in his previous post at Lothian Health Board. Durham GP

He said: ‘This guidance can't come quickly enough and it's heartening that the threat of community-acquired MRSA is being taken seriously.

‘It's particularly useful that comes in the form of specific clinical scenarios, not only on CA-MRSA but on how to spot hospital-acquired cases which present in the community.'

The final guidelines will be published in February and available on the HPA website.

MRSA: GPs to get key new role in tackling infection MRSA: GPs to get key new role in tackling infection

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