The North East and Cumbria antimicrobial prescribing guideline for primary care and quick reference guideline have been updated in line with new guidance from Public Health England around treatment of urinary tract infections (UTIs) and use of antibiotics in pregnancy.
Nitrofurantoin is now recommended as first line antibiotic for treatment of lower urinary tract infections in adults.
In pregnancy, if possible, avoid tetracyclines, quinolones, aminoglycosides, azithromycin, clarithromycin, high dose metronidazole (2g stat) unless the benefits outweigh the risks. Erythromycin is now the recommended treatment of acute sore throat in pregnancy in penicillin allergic patients.
Improving antibiotic stewardship is a priority for Public Health England due to the continuing threat of antimicrobial resistance. The Chief Medical Officer for England is sending her annual feedback letter on antibiotic prescribing rates to GPs in April 2017.
The feedback letters are being sent to over 6,300 individual GPs in over 1,400 different GP practices with high antibiotic prescribing rates. Practices were selected based on their level of prescribing per STAR-PU and in comparison with the England average used by the Quality Premium. The letters are tailored according to GP practice prescribing rate, change in prescribing over time, and whether they were previously sent feedback. While many GPs are already reducing their usage of antibiotics, the letters are intended to support GPs to reduce their prescribing further by providing feedback on practice prescribing rates, offering encouragement and suggesting practical actions in a clear and succinct manner.
This new guideline aims to make people aware of how to correctly use antimicrobial medicines and the dangers associated with their overuse and misuse in order to reduce antimicrobial resistance. It also includes measures to prevent and control infection.
Recommendations made by NG63 cover the following areas:
local system-wide approaches to reducing inappropriate antimicrobial demand and use
local system-wide approaches to preventing and limiting the spread of infection
childcare and education providers
prescribers, primary care, and community pharmacy teams.