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At the heart of general practice since 1960

Tougher guidelines on GP antibiotic prescribing planned

By Lilian Anekwe

The Department of Health's expert advisory committee on resistance has called for tougher, more consistent guidelines for GPs to curb the ‘inexorable rise' of resistant pathogens.

The Specialist Advisory Committee on Antimicrobial Resistance recommended the expansion of ‘prudent prescribing' drives from hospitals into primary care in its final report before handing over its responsibilities.

The hospital initiative concentrates on antibiotic use in children and infection control, and presses for tight scrutiny of prescribing and prescribers.

Former SACAR chair Professor Richard Wise, professor of clinical microbiology at City Hospital in Birmingham, said: ‘The link between prescribing, resistance and clinical outcomes needs to be addressed both in hospitals and communities.'

Professor Roger Finch, co-director of the University of Nottingham's centre for healthcare-associated infections and chair of SACAR's successor body, the Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infection, told Pulse providing GPs with better antibiotic prescribing guidance would be a key priority.

‘Prudent prescribing, wherever it takes place, needs to be based on clear indications for appropriate use,' he said.

His warnings came as new research published online by the BMJ showed prescribing amoxicillin to children in general practice doubled the risk of recovering resistant ß-lactamase-producing Haemophilus species after two weeks.

Professor David Mant, a researcher on the study and professor of primary care at the University of Oxford, advised GPs to avoid repeat prescriptions of amoxicillin.

‘When it is appropriate to repeat the prescription of an antibiotic within three months, it may be sensible to choose one such as co-amoxiclav that has activity against ß-lactamase-producing strains, rather than give amoxicillin,' he said.

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