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At the heart of general practice since 1960

OTC drive is over the top

It beggars belief that just a month after GPs were hauled over the coals for excessive antibiotic prescribing, the medicines regulator is to make the antibiotic most linked to resistance OTC.

It beggars belief that just a month after GPs were hauled over the coals for excessive antibiotic prescribing, the medicines regulator is to make the antibiotic most linked to resistance OTC.

You really couldn't make it up.

It's only a month since the national media sniffed in disdain at GPs' excessive antibiotic use.

‘The overprescription of antibiotics has been linked to the development of superbugs,' sighed the BBC, which said GPs were now being ‘told not to hand out antibiotics for common coughs and colds'.

But the antibiotic most frequently linked to resistance in recent studies is one commonly used not for respiratory tract infections, but for UTIs.

And that antibiotic – trimethoprim – is about to be made available over the counter, directly against the advice of many of the Government's leading clinical advisers.

It's a strange response to recent research showing GPs are leading the way in cutting antibiotic prescriptions for UTIs – and that this is having direct benefits for microbial resistance.

Not for the first time, Government policy seems not only confused but almost wilfully contradictory.

On the one hand ministers want GPs to take responsibility for everything from antibiotic use to sick leave, but on the other are removing responsibilities from GPs and handing them out like sweets to more favoured health professionals.

New front line

Top of the class among those professionals are pharmacists, who will not only form a new front line in antibiotic distribution, but look set to take a major role in the new vascular screening programme too.

Pharmacists may even be handed the power to give out statins – without the need for prescribing training – under proposals currently being considered by the Department of Health.

Except here too Government policy fails to add up.

Just last week, the Pharmacists' Defence Association warned the profession was so laden with extra work it was struggling to preserve patient safety.

It is hardly the ideal backdrop to one of the most dramatic shifts of responsibility from one group of health professionals to another in the history of the NHS.

Ministers seem convinced pharmacy is inherently cheaper, more accessible and more conducive to patient choice than general practice.

They seem equally certain that plans for pharmacists to have access to electronic records will dispel doubts over continuity of care.

So far, those assumptions have been allowed to go largely unchallenged – but some time soon that will have to change.

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