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THIS ARTICLE PUBLISHED BY NICE (NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE)

21 April 2016


Renewed call to tackle antimicrobial resistance

A long-term solution to antibiotic resistance can only be achieved if we act now, an expert has warned.

The comment comes as NICE launches a new quality standard which aims to help healthcare professionals and organisations tackle the problem.

Antimicrobial resistance to antibiotics is one of the greatest dangers to our health. Dame Sally Davies, the UK Chief Medical Officer, has described the threat as “catastrophic”. It could lead to people dying from ordinary infections, and routine operations such as hip replacements becoming deadly due to the risk of infection.

Last week, the Chancellor George Osborne warned that unless radical action is taken, it could lead to 10 million deaths each year by 2050. This is more than the number of people who die from cancer.

Yet despite these warnings, recent figures show that the use of antibiotics in the UK is increasing. Between 2010 and 2014, prescriptions rose in both primary and secondary, the sharpest rise of which was in hospitals. Consumption in general practice rose by 6.2%. And prescribing to hospital inpatients climbed by 11.7%.

NICE has published a new quality standard that aims to help reverse these trends and tackle the looming threat. The quality standard contains six statements which healthcare professionals can use to improve quality of care. It says that individuals and organisations need to work together to maintain the effectiveness of antimicrobials.

Majority of antibiotics prescribed in general practice

Figures show that the vast majority of antibiotics are prescribed in general practice. Between 2010 and 2014, three-quarters of antimicrobial prescribing occurred in primary care.

To address this, the quality standard calls for primary care professionals to educate people on when antibiotics are and are not needed. This is because people with common illnesses, such as coughs or colds, may not know that they are likely to get better without treatment.

Consequently, GPs should explain to patients why they are not being prescribed antibiotics, and give them advice on what they can do to help aid recovery.

Primary care prescribers should issue a prescription but ask patients to only collect their medicine if their symptoms have not improved after a few days.

NICE says GPs should use this approach if there is uncertainty about whether a condition will resolve on its own or is likely to deteriorate. It can save money by encouraging patients to manage their own conditions as a first step. But it also allows patients to access antibiotics without another appointment if their condition gets worse.

Act now to achieve a long-term solution

Elsewhere the quality standard calls for healthcare professionals to track data and provide feedback. This will allow them to check adherence to local formularies, provide feedback, recognise good practice and challenge inappropriate prescribing.

"Antimicrobial resistance is one of the greatest threats to our health,” said Dr Hugh McIntyre, consultant physician at East Sussex Healthcare Trust, and chair of the committee that developed the quality standard.

“The rise in antimicrobial resistance is linked to increased antibiotic prescribing. All healthcare professionals have a responsibility to work together to preserve the effectiveness of these treatments".

He added: “This quality standard calls for healthcare professionals to work together to tackle inappropriate prescribing. It addresses primary and secondary care, documentation of use, and accountability for stewardship.

"Since three quarters of antibiotic prescribing occurs in primary care, the engagement of GPs is of particular importance.

“We need to act now to if we are to achieve a long- term solution to this problem."

Professor Gillian Leng, deputy chief executive and director of Health and Social Care at NICE, added: “As healthcare professionals we need to work together, and act now, to tackle the real threat that antimicrobial resistance has for our health.

“By following the NICE quality standard, clinicians and organisations can help lower resistance to antimicrobials, and reduce the growing risk of deaths from infectious diseases.”