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Rate of GP prescribed antibiotics continue to soar

Rate of GP prescribed antibiotics continue to soar

There has been a 6% increase in the amount of antibiotics prescribed by GPs and hospitals between 2010 and 2013, according to a study published by Public Health England (PHE).

Posted: 17 October 2014

This is accompanied by an increase in the levels of antibiotic resistance.

Higher rates of antibiotic resistance were seen in areas with higher rates of prescribing.

The increased number of E. coli bloodstream infections corresponded to increased levels of resistance to a number of key antibiotics

  • ciprofloxacin resistance rose 18%
  • gentamicin resistance rose 27%
  • cephalosporin resistance rose 28%

The amount of antibiotics prescribed by GPs and hospitals rose 6% from 25.9 to 27.4 daily defined dose per 1,000 inhabitants daily.

Over the study period, the majority of prescribing was by GPs (78.5%), with 15.3% from hospital and 6.2% related to other community practitioners (mainly dentists).

The study also found a 32% increase in the amount of other community prescriptions (dentists and other non-GPs), which researchers noted was an area of concern.

Lead author Dr Susan Hopkins, a PHE healthcare epidemiologist said: “This publication marks a real move forward in our understanding of antibiotic prescribing habits as it’s the first time both GP and hospital prescribing data have been collated and prescribing trends analysed.

“The aim now must be to reduce levels of prescribing back to that seen in 2010. In addressing the issue of antibiotic resistance it is important to look at the whole healthcare economy approach. We must not underestimate how much work needs to be done to turn the tide and get levels of resistance down”.

Speaking to BBC Radio Berkshire, Dr Kieran Hand, Consultant Pharmacist in Anti-Infectives at University Hospital Southampton, attributed the increase in prescriptions for antibiotics to patients becoming more demanding, a shortening of time for GP consultation and GP’s anxiety in wanting to maintain their GP-patient relationship.

He pointed to the success of pilot studies in London pharmacies, which allowed pharmacists to perform tests for streptococcal infections in 15 minutes and then advise whether antibiotics were needed.

He claims pharmacists can play a key role in reducing antibiotic resistance when involved in prescribing.

“Specialist pharmacists in hospitals and pharmacist prescribing advisors in primary care have been successful in promoting a switch in choice of antibiotics away from cephalosporins and fluoroquinolones, leading to a significant reduction in Clostridium difficile infections.

“There is an important role for prescribing advisor pharmacists in CCGs to be trained to deliver educational messages to GP practices on how to safely reduce prescribing.”

The Department of Health (DH) last year implemented a five-year strategy to slow the development and spread of antimicrobial resistance and the World Health Organisation in April 2014 released a global report on antimicrobial resistance labelling it ‘a major threat to public health’.

PHE is responsible for organising European Antibiotics Awareness Day (EAAD) in the UK, held annually on 18 November.

The first annual report by PHE on English surveillance programme antimicrobial utilisation and resistance (ESPAUR) was published on the 10 October 2014 and covered the years 2010 to 2013. It presented antimicrobial use and resistance trends in primary and secondary care.