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At the heart of general practice since 1960

Kendrick on...the nonsense of the diet-heart hypothesis

So you thought dietary cholesterol was linked to CHD risk? Well think again. Dr Malcolm Kendrick, our new clinical columnist, begins his mission to question the unproven orthodoxies of general practice by making the case that the diet-heart hypothesis is scientific nonsence.

So you thought dietary cholesterol was linked to CHD risk? Well think again. Dr Malcolm Kendrick, our new clinical columnist, begins his mission to question the unproven orthodoxies of general practice by making the case that the diet-heart hypothesis is scientific nonsence.

The UK's drug regulator has sparked a new row on over-the-counter medicines after launching a consultation on plans to make an antibiotic for acute bacterial cystitis available in pharmacies.

The Medicines and Healthcare Products Regulatory Agency outlined proposals to allow women aged 16-70 with a prior diagnosis of cystitis to buy trimethoprim OTC.

GP experts in antibiotic use and cystitis immediately condemned the plans.

Dr Douglas Fleming, a GP in Birmingham and a member of the Government's Standing Advisory Committee on Antimicrobial Resistance, said: 'I wouldn't introduce an antibiotic over-the-counter as a blanket rule ­ I don't think it's a good move. [Chloramphenicol] was the thin end of the wedge and it's now a significant step.'

Professor Mike Kirby, professor of health and human sciences at the University of Hertfordshire and a GP in Letchworth, warned the move was 'highly likely' to lead to an increase in resistance.

He said cystitis symptoms could mask tumours or bladder stones and that problems with inadequate treatment could lead to silent infection and kidney damage. 'I would personally rather see the patient and deal with it myself.'

But Dr Jean-Pierre Dias, a GP in East Grinstead, West Sussex, who was vocal in his opposition to the decision to move chloramphenicol OTC, said the move was 'sensible' as it would cut GPs' workload.

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