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NICE calls for healthcare professionals to reduce unnecessary antibiotic prescribing

The National Institute for Health and Care Excellence has published guidance asking healthcare professionals to reduce antibiotic resistance by cutting back on unnecessary prescriptions

Nurse prescribers should be given updates at least once a year showing how their prescribing rates of antibiotics compare with other regional and national rates, the National Institute for Health and Care Excellence (NICE) has said.

It made this recommendation as part of guidance aimed at driving down the amount of prescriptions for antibiotics that health professionals write.

Prescribers may be encouraged to prescribe fewer antibiotics if they realise their rates are significantly higher than those of other health professionals. Practitioners should also be free to challenge prescribing practices of colleagues if they feel their rates are excessively high, the guidance states.

NICE is concerned that overuse of antibiotics has caused bugs to become resistant, and because very few new antibiotics have been developed in recent years. To compound the problem some health professionals come under pressure from patients to prescribe, when there is not always a need, it argues.

The guidance covers antimicrobial treatments generally, which include antibiotics and antiseptics.

It states: ‘Organisations should consider developing systems and processes for providing regular updates (at least every year) to individual prescribers and prescribing leads on: individual prescribing benchmarked against local and national antimicrobial prescribing rates and trends.’

Mark Baker, director of NICE’s Centre for Clinical Practice, 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.’

Professor Baker added that reporting doctors to the General Medical Council would be a last resort option to address inappropriate prescribing.

NICE also wants prescribers to have more detailed discussions with patients about whether antibiotics are needed, because in some cases there are alternative treatments and in others the conditions could clear up within a short time without the need for any medication.

Commissioners should ensure that they have ‘antimicrobial stewardship’ across all settings, involving a log of patient safety incidents, infections with clostridium difficile or adverse drug reactions such as anaphylaxis, and they should provide training to nurses and other health workers about antimicrobial resistance.

NICE plans to publish a second guideline next year that will focus on changing people’s knowledge, attitudes and behaviours in relation to the use of antibiotics.

Read the latest guidance here

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