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GPs should reduce antibiotic prescribing for COPD, says NICE



GPs should limit the amount of antibiotics that they prescribe to COPD patients experiencing exacerbations, according to new draft guidance from NICE.

GPs should reserve antibiotics for severe exacerbations only and take in to account symptoms and history inpatients whose exacerbation is not severe before prescribing, according to NICE.

The guideline recommends that patients with severe acute exacerbations are prescribed an antibiotic and that in non-severe exacerbations, GPs should consider factors such as the number and severity of symptoms, their previous exacerbation history and the risk of antimicrobial experience before prescribing antibiotics.

The guideline also suggests that if an antibiotic is prescribed, the choice of drug should be reviewed when microbiological results from a sputum sample become available.

It reminds GPs that exacerbations can be caused by factors such as viral infections and smoking and advises on safety-netting if the decision is made not to prescribe.

Professor Mark Baker, director of the centre for guidelines at NICE, said: ‘The evidence shows that there are limited benefits of using antibiotics for managing acute exacerbations of COPD and that it is important other options are taken into account before antibiotics are prescribed.

‘The new guideline will help healthcare professionals make responsible prescribing decisions to not only help people manage their condition but also reduce the risk of resistant infections.’

The draft COPD antimicrobial prescribing guideline is open for consultation until 31 July 2018.