No More Mister NICE Guy for Antibiotic Prescriptions

[box]Anamika Kunnumpurath reports on new NICE guidelines for the use of antibiotics [/box]

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Antibiotics, once a symbol of the power of advancing science and modern medicine, are increasingly being used with caution and viewed with a critical eye. New guidelines published earlier this month by NICE have highlighted the need for a change in how antibiotics are prescribed and stricter policies to be put in place in order to help impede the rising tide of antibiotic resistance.

A fundamental part of their guidelines is the term “antimicrobial stewardship”, which may sound complicated but actually embraces a straightforward concept. Their guidance suggests ‘an organisational or healthcare-system-wide approach’ to encourage the prudent administering of antibiotics so that these drugs may continue to be invaluable to those patients faced with life threatening infections.

According to NICE, 41.6 million antibiotic prescriptions were issued in 2013/2014 and their recent guidelines have been drafted as a measure to tackle what is now seen as a healthcare crisis. They aim to support prescribers in making well-informed decisions with regards to the administration of antimicrobials and promote a peer-review process that allows practitioners to raise concerns over colleagues with questionable prescribing habits.  The Director of the Centre for Clinical Practice at NICE, Professor Mark Baker, has firmly stated that if health professionals “fail to come into line…there are a number of performance processes that the General Medical Council, or in the case of dentists, the General Dental Council, can use to improve the clinical performance of practitioners.”

Prof. Baker’s suggestion of sanctioning doctors who overprescribe has not been well received by the Royal College of GPs. The College’s Dr. Tim Ballard raises the point that there remains the critical need for “societal change”, calling for a shift in focus away from punishing “hard-pressed GPs’ towards demolishing the antibiotics ‘culture’ that prevails in our society. The guidelines provide protocols that hone in on how healthcare practitioners may improve their prescribing habits and perform audits for regular review, but more direction is needed with regards to how we can encourage a sense of responsibility at a community level amongst the lay population.

Setting all differences aside, the problem that propels this debate is universal. Behind these guidelines and strategies lies the fact that we are running out of time. We can no longer afford to add to the growing pool of drugs that bacteria have developed resistance to and must engineer new tactics to manage both the administration of antibiotics whilst simultaneously tackling their deep-rooted overuse. There is no question that Antibiotics save lives but whether they will continue to do so, and stand the test of time, is a question that remains to be answered.

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