GP warning on antibiotic overuse

Michael Moore, who is Reader in Primary Care Research at the University and a GP, is also encouraging GPs to avoid prescriptions of antibiotics when there is likely to be little benefit for the patient.

Dr Moore's comments come ahead of European Antibiotic Awareness Day (18 November), which aims to highlight risks associated with inappropriate use of antibiotics and how to take antibiotics responsibly.

Dr Moore and colleagues at the University of Southampton have been conducting research, led by Professor Paul Little, into antibiotic overuse during the past decade, which focuses on the management of self-limiting illness in primary care. 

Dr Moore comments: "Antibiotic resistance is an international problem with the real prospect of untreatable serious infections in the next 10 to 20 years.  In the past 60 years antibiotics have been widely used for both minor and major infection, however it is now apparent that widespread use leads to antibiotic resistance and since there is little prospect of new antibiotics being developed, we need to change the culture of use to preserve the antibiotics currently available.

"We now have clear evidence that antibiotics have a marginal effect in respiratory infections, it is imperative that we rethink current use patterns and avoid prescriptions when there is likely to be little benefit in order to preserve antibiotics for serious life threatening illness. Most antibiotics (80%) are prescribed by GPs of which about half are prescribed for respiratory infection.

"The problem is that some people develop serious complications of their respiratory illness, for instance pneumonia or quinsy (a throat abscess following tonsillitis).  I know from my own practice how hard it is for GPs to spot the people who really need the antibiotics.  The research program at Southampton has focused on this problem over the last 10 years. We have looked at ways of better targeting antibiotics for those at high risk using risk scores, new technology such as instant reading throat swabs - to diagnose the more serious throat infection, and pioneering alternative prescribing strategies, such as delaying the start of the prescription for a few days to see if symptoms settle on their own."

Dr Moore has been working with the Royal College of General Practitioners (RCGP) to help launch a toolkit containing new guidance for GPs and their patients on the appropriate prescription of antibiotics. The guidance provides a simple, effective, and cost-efficient approach to the treatment of common infections to minimise the emergence of bacterial resistance in the community. It is launched as part of a TARGET toolkit (Treat Antibiotics Responsibly, Guidance and Education Tool) available on the RCGP website [www.RCGP.org.uk\TARGETantibiotics\] and has been produced in partnership with the Health Protection Agency (HPA) and the Antimicrobial Stewardship in Primary Care Group (ASPIC). 

The partnership has helped to ensure a variety of health professionals have contributed to  the resource including, microbiologists, clinicians, GPs, pharmacists, guidance developers and other stakeholders. Dr Moore is the RCGP Clinical Champion for Antimicrobial Stewardship, a clinical priority program.

The new RCGP website brings together research findings from the University of Southampton and other centers into a single resource to enable GPs to access the latest findings and find tools to help them in their practice to modify prescribing patterns.  More information will be added to the site as it is published.

Dr Moore adds: "The toolkit is aimed at working GPs to give them the means to assess their current practice and to focus on ways to reduce antibiotic prescribing in situations where the evidence shows they are of little or no benefit. We will be adding to the toolkit over time as more evidence comes available. I don't see antimicrobial stewardship as a one off activity rather as something to be worked on over time. We hope that practices will pick up on antibiotic awareness and integrate this into their service development programme over the coming years, perhaps focussing on a different clinical condition each year."

Michael Moore, who is Reader in Primary Care Research at the University and a GP, is also encouraging GPs to avoid prescriptions of antibiotics when there is likely to be little benefit for the patient.

Dr Moore’s comments come ahead of European Antibiotic Awareness Day (18 November), which aims to highlight risks associated with inappropriate use of antibiotics and how to take antibiotics responsibly.

Dr Moore and colleagues at the University of Southampton have been conducting research, led by Professor Paul Little, into antibiotic overuse during the past decade, which focuses on the management of self-limiting illness in primary care.

Dr Moore comments: “Antibiotic resistance is an international problem with the real prospect of untreatable serious infections in the next 10 to 20 years. In the past 60 years antibiotics have been widely used for both minor and major infection, however it is now apparent that widespread use leads to antibiotic resistance and since there is little prospect of new antibiotics being developed, we need to change the culture of use to preserve the antibiotics currently available.

“We now have clear evidence that antibiotics have a marginal effect in respiratory infections, it is imperative that we rethink current use patterns and avoid prescriptions when there is likely to be little benefit in order to preserve antibiotics for serious life threatening illness. Most antibiotics (80%) are prescribed by GPs of which about half are prescribed for respiratory infection.

“The problem is that some people develop serious complications of their respiratory illness, for instance pneumonia or quinsy (a throat abscess following tonsillitis). I know from my own practice how hard it is for GPs to spot the people who really need the antibiotics. The research program at Southampton has focused on this problem over the last 10 years. We have looked at ways of better targeting antibiotics for those at high risk using risk scores, new technology such as instant reading throat swabs – to diagnose the more serious throat infection, and pioneering alternative prescribing strategies, such as delaying the start of the prescription for a few days to see if symptoms settle on their own.”

Dr Moore has been working with the Royal College of General Practitioners (RCGP) to help launch a toolkit containing new guidance for GPs and their patients on the appropriate prescription of antibiotics. The guidance provides a simple, effective, and cost-efficient approach to the treatment of common infections to minimise the emergence of bacterial resistance in the community. It is launched as part of a TARGET toolkit (Treat Antibiotics Responsibly, Guidance and Education Tool) available on the RCGP website [www.RCGP.org.uk\TARGETantibiotics\] and has been produced in partnership with the Health Protection Agency (HPA) and the Antimicrobial Stewardship in Primary Care Group (ASPIC).

The partnership has helped to ensure a variety of health professionals have contributed to the resource including, microbiologists, clinicians, GPs, pharmacists, guidance developers and other stakeholders. Dr Moore is the RCGP Clinical Champion for Antimicrobial Stewardship, a clinical priority program.

The new RCGP website brings together research findings from the University of Southampton and other centers into a single resource to enable GPs to access the latest findings and find tools to help them in their practice to modify prescribing patterns. More information will be added to the site as it is published.

Dr Moore adds: “The toolkit is aimed at working GPs to give them the means to assess their current practice and to focus on ways to reduce antibiotic prescribing in situations where the evidence shows they are of little or no benefit. We will be adding to the toolkit over time as more evidence comes available. I don’t see antimicrobial stewardship as a one off activity rather as something to be worked on over time. We hope that practices will pick up on antibiotic awareness and integrate this into their service development programme over the coming years, perhaps focussing on a different clinical condition each year.”