Improve rapid diagnostics to support GP antibiotic prescribing, experts say

GPs need better access to rapid diagnostic services if they are to reduce antibiotic use and limit the spread of antimicrobial resistance, an expert has said.

Amoxicillin: resistance has grown in recent years (Photo: SPL)
Amoxicillin: resistance has grown in recent years (Photo: SPL)

Giving GPs access to diagnostic tests with a faster turnaround to steer antibiotic treatment would help reduce inappropriate use, according to Dr Stephanie Dancer, a consultant microbiologist at NHS Lanarkshire.

Pressure is growing on GPs to reduce antibiotic prescribing amid rising levels of antimicrobial resistance. A recent WHO report called on doctors to prescribe the drugs 'only when genuinely needed'.

Speaking at a session on antimicrobial resistance at the NICE annual conference this week, Dr Dancer said: 'The best thing to do is to support our GP colleagues by offering a rapid diagnostic service that doesn't necessarily come from centralisation of microbiology labs. But also to build up relationships between hospitals in the community, so much so that GPs have confidence in microbiology laboratory and the advice that goes with it.'

She said this advice would give GPs the confidence to tell patients whether or not their symptoms would benefit from taking antibiotics.

Dr Dancer added that a huge marketing drive was needed to increase awareness of the threat of antimicrobial resistance.

'I pull up reports from laboratories and I can see that seven years ago, if you chose amoxicillin to treat a UTI, you had a 50% chance of success. Now, I'm afraid, it would be about 20%.'

She said: 'It's about time we had a full-scale, multimedia advertising campaign for everybody - not just the public. It's about mushrooming this message that we are running out of antibiotics.'

There should be more attention on antimicrobial resistance in medical training, she added.

Benchmarking must improve

Claire Boville, head of policy for healthcare-associated infections at the DH, said the NHS needed to improve data collection on antibiotic use and resistance so it could identify pockets of good and bad practice and adopt a culture of local benchmarking.

'There's a lot of good work going on, but it's happening at a very local level. The lessons being learned in one institution or area are not necessarily being transferred and that learning shared,' she said.

England's CMO Professor Dame Sally Davies has said greater use of rapid diagnostics to enable tailored approaches to antibiotic treatment are a 'key area' of innovation to tackle antimicrobial resistance.

The UK government has committed to improve access to the tests in its five-year antimicrobial resistance strategy that followed the CMO report.

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