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NICE: Health professionals need to question colleagues overprescribing antibiotics

Health professionals need to be able to question colleagues who unneccesarily prescribe antibiotics, the National Institute for Health and Care Excellence (NICE) has said in new guidance to help doctors, nurses and pharmacists promote and monitor their sensible use.

Overall, antibiotic prescribing in England has been steadily increasing over several years. Nationally, 41.6 million antibiotic prescriptions were issued in 2013-14, costing the NHS £192 million.

Despite considerable guidance that prescribing rates of antibiotics should be reduced, nine out of 10 GPs say they feel pressured to prescribe antibiotics, and 97% of patients who ask for antibiotics are prescribed them, NICE said.

Commenting on the guidance, Professor Mark Baker, director of the Centre for Clinical Practice at NICE, said:  “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.

“It's not just prescribers who should be questioned about their attitudes and beliefs about antibiotics”, continued Professor Baker. “It's often patients themselves who, because they don't understand that their condition will clear up by itself, or that perhaps antimicrobials aren't effective in treating it, may put pressure on their doctor to prescribe an antibiotic when it is not indicated and they are unlikely to benefit from it.”

The guidance 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.

Antibiotics have been the mainstay of treating infections for more than 60 years. Although a new infectious disease has been discovered nearly every year over the past 30 years, very few new antibiotics have been developed.