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CAMHS won't see you now

NHS clamps down on antibiotics for common infections

The NHS has moved to clamp down on antibiotic use by issuing detailed prescribing advice urging delayed or no prescribing for a range of common infections.

The National Prescribing Centre has reviewed data on antibiotic use and found only a minority of cases where there is evidence of benefit.

But the guidance has proved controversial, with some experts suggesting patients with early pneumonia could miss out on treatment.

The document discourages GPs from prescribing antibiotics routinely for acute sinusitis, acute bronchitis, sore throat and acute otitis media – stressing instead 'a strategy of watchful waiting and use of delayed prescriptions'.

Dr Neal Maskrey, the centre's director of evidence-based therapeutics, said GPs could use the recommendations to make 'an informed decision'. 'It might be useful not to think of our approach as "prescribe fewer antibiotics" but rather "try and identify those patients with common infections for whom antibiotics might be of benefit". Other patients may be better managed by symptomatic treatment or a delayed prescription.'

Patients and parents of children with infections should be reassured that most infections are mild, self-limiting and will resolve themselves within a week, the centre said.

Dr Ian Williamson, senior lecturer in the department of primary medical care at the university of Southampton, said he would 'certainly support' the recommendations. He said he delayed prescribing to more than 70 per cent of the patients with common infections at his surgery in Southampton.

'The evidence is good that antibiotics are of limited use at best. But there is plenty of scope for improvement – the message still needs to be reinforced.'

But Dr Andrew Hayward, senior lecturer in infectious disease epidemiology at University College London, warned the new guidance on chest infections could be 'difficult because of the difficulties in excluding pneumonia in primary care'.

'At the moment GPs seem to be prescribing antibiotics to the great majority of people with what they're describing as chest infections, so following these recommendations would be quite a change in practice.'

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