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The impending antibioticlypse



I’m really not trying to stomp on the green shoots of mid/post Covid recovery. But I do feel it’s my responsibility to flag up another crisis heading our way. And that’s amoxigeddon. Or the ciprofloxalypse. Or a cataclarithromysm. And if you think that word play doesn’t work, that’s my point. Because nor will the antibiotics. They will have been used and abused into oblivion.

Consider this honeymoon period of remote consulting that we’re currently experiencing. Then invert the prevailing low demand, light touch, sunny days, manageable workload, no complaint, QOF/appraisal-free climate to more accurately reflect what midwinter might look like.

You’re seeing a vision of hell, right?

Now imagine what your antibiotic threshold might be. We all have different prescribostats, true, and I’m happy to declare that mine is traditionally set somewhere near zero. But it’s much easier to be confident about not prescribing, and certainly easier to convince patients, when you’ve done a F2F and a ‘thorough examination’.

The result will be an all-u-can-eat antibiotic policy

So even I, who regards each amoxicillin script I issue as a slap around my professional face, find that remote consulting has upped my ‘just in case’ prescription habit. God knows what my threshold will reduce to in January, if I have one at all.

Besides, from the patient perspective, the summer of love-for-the-NHS is bound to become a winter of discontent: there’s all that pent-up antipathy to be vented. And no-one ever heard of a patient complaining about a GP for prescribing antibiotics, only the opposite.

The result will be an all-u-can-eat antibiotic policy, with the risk of driving a coach-and-horses through current efforts to reduce antimicrobial resistance. Unless, of course, we run out of them, which might just happen.

Our only way of avoiding the end-of-prescribing-as-we know-it is for the apocalyptic horsemen to be headed off at the pass. Which means public health being brave enough to mount a massive and hard-hitting campaign steering the wintry viral away from us – and that’s a big ask for an organisation whose previous mindset has been to suggest that every cough equals cancer.

It really shouldn’t be that difficult. Patients, that winter cough will pass, so ignore it. Unless that person you see on horseback is carrying a scythe.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield