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Antibiotic resistance: new guidelines released
antibiotics
Nine out of 10 GPs feel pressured by patients to prescribe antibiotics.
Guidelines highlight need for stewardship programmes

The National Institute for Health Care and Excellence (NICE) have released new guidelines to tackle the growing threat of antibiotic resistance.

The draft guidelines are intended to help health and social care commissioners, providers and prescribers promote and monitor the sensible use of antimicrobials to preserve their effectiveness in the future.

In addition to highlighting the need for local antimicrobial stewardship programmes, the draft guidelines also recommend setting up multidisciplinary antimicrobial stewardship teams working across all care settings. They state that these teams should be able to review prescribing and resistance data frequently and feed this information back to prescribers.

Commenting on the guidelines Professor Mark Baker, director of the Centre for Clinical Practice at NICE, said: "This draft guidance recognises that we need to  encourage an open and transparent culture that allows health professionals to question antimicrobial prescribing practices of colleagues when these are not in line with local and national guidelines and no reason is documented."

However, Professor Baker believes that it is not just prescribers who should be questioned about their attitudes and beliefs to antibiotics.

He adds: “It’s often patients themselves who, because they don’t understand that their condition will clear up by itself, or that perhaps antibiotics aren’t effective in treating it, may put pressure on their doctor to prescribe an antibiotic.

"Nationally, 41.6 million antibacterial prescriptions were issued in 2013 -14 at a cost to the NHS of £192 million. Despite considerable guidance that prescribing rates of antibiotics should be reduced, nine out of 10 GPs feel pressured to prescribe antibiotics, and 97 per cent of patients who ask for antibiotics are prescribed them.

"The draft guideline therefore recommends that prescribers take time to discuss with patients the likely nature of their condition, the benefits and harms of immediate antimicrobial prescribing, alternative options such as watchful waiting and/or delayed prescribing and why prescribing an antimicrobial may not be the best option for them."

Welcoming the guidelines, Dr Maureen Baker, chair of the Royal College of GPs, said: “Antibiotics have served us well in treating infections for over 60 years, but as a society we have become too dependent on them and they are now seen as a ‘catch all’ for every illness and infection.

"GPs can come under enormous pressure from patients to prescribe antibiotics so we welcome a team approach to ensuring that this is done appropriately and that they are used responsibly."

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Birmingham Dogs Home makes urgent appeal

News Story 1
 Birmingham Dogs Home has issued an urgent winter appeal as it faces more challenges over the Christmas period.

The rescue centre has seen a dramatic increase in dogs coming into its care, and is currently caring for over 200 dogs. With rising costs and dropping temperatures, the charity is calling for urgent support.

It costs the charity £6,000 per day to continue its work.

Fi Harrison, head of fundraising and communications, said: "It's heart-breaking for our team to see the conditions some dogs arrive in. We really are their last chance and hope of survival."

More information about the appeal can be found here

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News Shorts
Avian flu confirmed at premises in Cornwall

A case of highly pathogenic avian influenza H5N1 has been detected in commercial poultry at a premises near Rosudgeon, Cornwall.

All poultry on the infected site will be humanely culled, and a 3km protection zone and 10km surveillance zone have been put in place. Poultry and other captive birds in the 3km protection zone must be housed.

The case is the second avian flu case confirmed in commercial poultry this month. The H5N5 strain was detected in a premises near Hornsea, East Riding of Yorkshire, in early November. Before then, the disease had not been confirmed in captive birds in England since February.

The UK chief veterinary officer has urged bird keepers to remain alert and practise robust biosecurity.

A map of the disease control zones can be found here.