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Antibiotics dropped from pharmacy access scheme after resistance concerns



Exclusive Pharmacy leaders have rowed back from including several antibiotics in a pharmacy access scheme making the drugs available without an individual prescription, after a meeting with the Department of Health.

The antibiotics trimethoprim, doxycycline and ciprofloxacin will now be removed from the scheme which is designed to offer prescription-only medicines (POMs) without an individual prescription and which will be rolled out to up to 12,500 pharmacies this month.

But the scheme will still include medicines such as salbutamol inhalers and sildenafil.

The last-minute change to the scheme came after GP leaders raised concerns over the plans to offer a raft of patient group directions to all members of the National Pharmacy Association, after a pilot in Day-Lewis pharmacies.

The DH also said it had concerns over the scheme, and organised a meeting with the NPA and Day-Lewis Pharmacy before Christmas.

In a joint statement to Pulse, they said that they had agreed at the meeting that all antibiotics apart from azythromycin would be removed from the scheme to prevent increasing antibiotic resistance.

The NPA also agreed to provide the DH with data from the pilots, so that the patient group directions under which the drugs are dispensed could be evaluated.

In order to offer the scheme, pharmacists have to complete additional training online, with patients able to obtain medicines after completing an online medical questionnaire and having a face-to-face consultation with the pharmacist or using a walk-in service.

A joint statement from the DH, the NPA and Day Lewis Pharmacy, said: ‘The chief pharmaceutical officers welcome NPA’s decision not to include PGDs involving antibiotics in the service going forward. This underlines their support in helping to combat antimicrobial resistance.’

‘An exception to this is the use of azithromycin in the treatment of chlamydia, which is an established and effective way to treat this sexually transmitted disease in a safe and convenient way, following a laboratory positive chlamydia test.’

‘The chief pharmaceutical officers acknowledged that the NPA had gone to some lengths to provide a robust PGD service and welcomed the NPA’s offer to provide data on the evaluation of the pilot scheme on the use of PGDs for a range of conditions.’

‘This will help inform future consideration of how best to use PGDs in the armoury of methods to improve safe access to the medicines the public need and meeting public health objectives.’

Dr Bill Beeby, chair of the GPC’s clinical and prescribing subcommittee, said: ‘While recognising that removing antibiotics from the scheme is an improvement, I still have concerns.’

‘These organisations take on these schemes without looking at the wider issues. And as I predicted, if one does it, all of them do it.’

He said that there was already provision for treating chlamydia: ‘Prescribing azithromycin for chlamydia is already covered by a LES, organised by the local health community or PCT or CCG, so we shouldn’t need an outside organisation to provide this.’

 

Drugs that will be available without a prescription as part of the NPA scheme:

Sildenafil

Tadalafil

Vardenafil

Azithromycin

Ulipristal

Salbutamol

Fexofenadine

Calcipotriol

Malarone

Mefloquine

Hyoscine patches

Drugs removed from the scheme:

Trimethoprim

Ciprofloxacin

Doxycycline