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Independents' Day

Official rethink on antibiotics as pneumonia deaths soar

The Government has revealed it is reviewing its policy on anti-biotic prescribing as fears grow that GPs' success in cutting scripts may have caused a big rise in pneumonia mortality.

Leaders of a new study, due to be published in Respiratory Medicine in January, say the Government may have gone too far and caused GPs to

deny lifesaving antibiotics to pneumonia patients.

The Government's specialist advisory committee on

antimicrobial resistance was due to meet last week to

consider updating advice on antibiotic use for lower respiratory tract infections.

The study from the University of Aberdeen shows winter excess pneumonia mortality increased from 20.4 deaths per 100,000 to 30.7 between 1995/6 and 1999/2000. Community antibiotic prescriptions for LRTIs fell 30 per cent over the same period.

Study co-author Dr Mike Thomas, a GP and clinical research fellow at the university, said the substantial decrease

in antibiotic prescribing for LRTIs was surprising.

The landmark 1998 Standing Medical Advisory Committee's guidelines recommended antibiotics should not be used to treat common coughs, colds and sore throats ­ but that if a bacterial infection was suspected and judged to present a sufficient health risk then antibiotics should be prescribed.

But Dr Thomas, a GP in Stroud, said the difficulty in diagnosing pneumonia was well known and delayed or insufficient antibiotic treatment could cause harm in some patients. He added: 'We can't say there is a cause and effect relationship but it does ring alarm bells.'

Dr Douglas Fleming, director of the RCGP Birmingham research unit and a member of the specialist advisory committee on antimicrobial resistance, said the group would consider various points of view.

He added: 'Doctors' judgments might be better than more guidelines.'

·Chief Medical Officer Professor Sir Liam Donaldson wants to give PCTs a formal right to challenge GPs' antibiotic prescribing decisions in a bid to cut health care-associated infections caused by growing antimicrobial resistance. Sir Liam last week called for every PCT to appoint a director of infection prevention.

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