National summit calls for ‘rollback’ of antibiotic prescribing

At a summit today in London, GPs, hospital doctors, nurses and pharmacists are calling for binding national “rollback” targets on antibiotic prescribing to halt the relentless rise in antibiotic resistance.

The impact of antibiotic resistance has been compared to climate change in terms of its impact on human health.  Healthcare without effective antibiotics is unthinkable to those who have enjoyed the benefits of modern medicine. The stark reality of a world where simple infection and routine surgery become deadly is ahead unless we take action now.

Leading experts from across the professional spectrum are calling for national measures to be implemented across the NHS without delay.

The headline measure that is being called for is to roll back total consumption of antibiotics to 2010 levels in both community and hospital settings.

The mandate for this action is clear. Public Health England reported in October that between 2010 and 2013 there was a 6% increase in the combined antibiotic prescribing of GPs and hospitals.

The report showed a wide variation in both prescribing and antibiotic usage across England. Crucially, there is more antibiotic resistance in geographical areas that have higher rates of prescribing.

Reducing the use of antibiotics is one of many important actions that need to be taken to reduce antibiotic resistance. Today’s “Antimicrobial Resistance Summit” will move the debate on to how we can take practical actions in the hospital, surgery, clinic and pharmacy to make this happen.

Philip Howard, Consultant Pharmacist in antimicrobials and spokesperson for the Royal Pharmaceutical Society said: “Antibiotics save lives. Anyone who comes to my hospital with an infection will get an antibiotic promptly when it is the right choice of treatment. I believe we will be able to meet these challenging targets by ensuring we all use antibiotics more carefully, and by fine tuning or stopping the antibiotic when test results are known. Where an infection is proven, we need to complete the course of antibiotics. This will lead to better patient care as well as reduced resistance. I believe these two aims are compatible and mutually supportive.”  

Dr Susan Hopkins, Lead on healthcare associated infections for the Royal College of Physicians said: “Each and every doctor and prescriber has a responsibility to prescribe the right antibiotic to the right patient at the right time. However we must reduce prescribing to the lowest safest levels. In primary care evidence from clinical trials show that less antibiotics are used if GPs use back-up (delayed) prescriptions. In secondary care, prescribers should review prescriptions daily and consider whether antibiotics can be safely stopped or a narrow-spectrum antibiotic prescribed.”

Rose Gallagher, RCN Adviser for Infection Prevention and Control, said: “Antimicrobial resistance is increasingly recognised as one of the major health challenges of our age. It is worrying that many antibiotics could become ineffective if we don’t get to grips with the threat posed by antimicrobial resistance.  Robust quality measures are essential for guiding our individual and collective efforts to reduce the risk of AMR.

“Nursing staff have a key role to play in limiting AMR through their leadership and skills supporting infection prevention, antimicrobial stewardship, and public health. The nursing profession is determined to support this important work both in the UK and internationally.”

Professor Nigel Mathers, Honorary Secretary of the Royal College of General Practitioners, said:  “Antibiotics can work brilliantly as long as they are properly prescribed and used appropriately, but we have developed a worrying reliance on them and some of our patients now see them as a cure-all.

“Health professionals can face enormous pressure to prescribe them but all of our patients and the public need to be aware of the risks associated with inappropriate use of antibiotics and how to use them appropriately.

“It is absolutely imperative that all of us – doctors, nurses and pharmacists – work in partnership with our patients to talk about when antibiotics are necessary and when they are not required. We should also be pointing out the alternatives available to those of our patients who ask for antibiotics to treat viral illnesses.

“We need to do everything we can to prevent resistance to antibiotics so that we can all benefit when we really need them.”