MPs call for 'more challenging targets' to cut GP antibiotic prescribing

MPs have called for more challenging antibiotic prescribing targets for primary care and steps to prevent hospitals using them unnecessarily in a report that calls for tackling antimicrobial resistance to be a 'top five policy priority' for the government.

Health and social care committee chair Dr Sarah Wollaston (Photo: JH Lancy)
Health and social care committee chair Dr Sarah Wollaston (Photo: JH Lancy)

Despite recent improvements on antibiotic prescribing, UK use of the drugs remains 'approximately double that of the Netherlands, Sweden and the Baltic states', a report from the House of Commons health and social care select committee warns.

The report warns that despite welcome NICE guidance on use of antimicrobial drugs, evidence suggests the advice 'just does not get into practice'. It calls for 'more challenging targets for primary care, and for rapid review and withdrawal of clinically unnecessary secondary care prescribing' - with 'concerted action' from NHS England to enforce responsible prescribing.

BMA leaders warned that doctors need more time with patients and a reduction in workload to make the right decisions about when to prescribe antibiotics.

Prescribing

With all prescriptions now issued electronically, it should be simple to ensure that appropriate prescribing of antibiotics becomes the default option, the MPs' report says. IT systems should prompt doctors to make sure that they have followed all necessary steps to check that antibiotics are needed - but the report found that 'simple, low cost interventions such as issuing delayed prescriptions, which have proven efficacy in safely reducing antibiotic use, can still be very difficult to put into practice on standard GP prescribing systems'.

The report calls for better access to rapid tests to identify whether antibiotics are needed, where NICE approves the tests. It also calls for measures to incentivise pharmaceutical companies to invest in finding new antibiotics, further controls on antibiotic use in animals and government action to 'raise the profile of antimicrobial resistance (AMR) both at home and on the international stage'.

Committee chair and former GP Dr Sarah Wollaston said: 'In six months we want to see tangible progress on implementing practical policies to reverse the worrying exodus from AMR research and development and both government and industry should play their part in tackling this issue.'

Limiting healthcare

BMA board of science chair Professor Dame Parveen Kumar said: 'The BMA agrees that the government should put AMR at the forefront of its agenda. The increase in AMR has the potential to severely limit the treatment of many infections and routine and complex medical procedures.'

Professor Kumar said the BMA recognised that co-ordinated action was required 'across medicine, veterinary practice and agriculture'.

She added: 'It is vital that we make progress on minimising the use of antibiotics to only those patients for whom it is absolutely necessary. In order to do this, we must also recognise the environment in which prescribing takes place in both primary and secondary care, and the level of patient demand that healthcare staff are currently facing.

'For real change to happen it is vital that doctors have adequate time with patients for conversations and considered decision-making about antimicrobial prescribing, as well better access to diagnostic testing.'

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