It is always good to have robust evidence-based advice when it comes to prescribing.
And NICE's recent guidelines on the treatment of throat infections, which promote the use of paracetamol without recourse to antibiotics, should be celebrated on two levels.
Firstly, it means patients will now have the best chance of a resilient recovery. NICE notes that 'evidence reviewed found most people will get better without antibiotics, usually experiencing symptoms for up to a week. However, research suggests antibiotics are prescribed in 60% of cases'.
Secondly, and following on from Public Health England’s winter advertising drive 'Keep Antibiotics Working', it is encouraging to see that nationally we are proactively promoting a reduction in needless antibiotic usage.
This chimes with World Health Organisation policy; and it is entirely apposite to remind ourselves of their repeated warning that antibiotic resistance is one of the biggest threats to global health, food security, and development today. That view has recently been echoed by England’s chief medical officer Dame Sally Davies who, in an interview with The Guardian, said: 'We really are facing – if we don’t take action now – a dreadful post-antibiotic apocalypse'.
Pressure from patients
One of the oft-touted reasons for antibiotic resistance is over-prescribing of antibiotics. Working with GPs in a range of different geographical areas, ANTRUK has heard about the pressure patients exert to get their hands-on antibiotics, with some even having to be escorted from practices when refused medication or threatening to report their doctor to the GMC.
Antibiotics – despite a dearth in the development of new ones – are still seen as cure-all wonder-drugs and symptomatic of a 'Get Fit Quick' attitude that is often fuelled by employers (and sometimes even schools) aiming to reduce sickness levels regardless of consequence.
Practitioners need more protection, which can only be promoted through public education. It is in everyone’s interest to reduce overuse of antibiotics and hence help reduce antibiotic resistance. In return, GPs need to be consistent in their rigour when prescribing antibiotics and act as ambassadors in the fight against antibiotic resistance.
ANTRUK is calling for the creation of a grand alliance of the UK government, pharmaceutical industry, collective medical research charities, academics and the public to produce a UK-focussed plan to tackle the problem.
But we also value the support of medics, whether they are hospital infection control teams informing us about superbugs, doctors dispensing sensible levels of antibiotics or practice teams raising awareness with their patients.
Antibiotic resistance is a mighty problem that can only be tackled by a whole-society approach. Primary care has a pivotal role in that process. And while we wouldn’t want you to make your throats sore with shouting, we would like you to join with us and speak up, speak out and play your part in preserving good health for generations to come.
- Professor Colin Garner is the founder and chief executive of Antibiotic Research UK (ANTRUK), the only charity in the world working specifically to tackle bacterial antibiotic resistance. Learn more by visiting www.antibioticresearch.org.uk