London - Doctors will have to spend more time explaining to their patients why they cannot receive antibiotics for minor infections according to new medical guidelines.
The guidelines are aimed at reducing prescriptions and curbing the rise of drug-resistant “superbugs”.
The new guidance will target “soft touch” GPs who, under pressure from patients, prescribe antibiotics for illnesses such as viral infections that do not respond to the drugs.
The National Institute for Health and Care Excellence (Nice) said that the medical profession as well as patients need to realise that the continuing rise in antibiotic prescriptions needs to be reined-in.
NHS staff are being advised not to issue immediate prescriptions. Patients can be asked to come back within three or five days if their symptoms persist or they can be issued with date-delayed prescriptions, the new Nice guidelines say.
The use of antibiotics has risen steadily over recent years with 41.6 million NHS prescriptions issued last year in England alone at a cost of £192m. Nine out of 10 GPs say they feel pressurised to issue the prescriptions and 97 percent of patients who ask for them are prescribed them, Nice said.
As many as 10 million prescriptions - about a quarter of the annual total - are being given unnecessarily to patients who will not benefit from the drugs, Professor Baker said.
“It's entrenched in our society. There are people who are addicted to the idea of having antibiotics. If they know there's a soft-touch doctor then they go to them. Often they'll go to their GP and then try another one [if they do not prescribe them],” said Professor Mark Baker, director of the Centre for Clinical Practice at Nice.
“It's not just prescribers who should be questioned about their attitudes and beliefs about antibiotics. It's often patients themselves who, because they don't understand that their condition will clear up by itself or that perhaps antimicrobials aren't effective in treating it, may put pressure on their doctor to prescribe an antibiotic when they are unlikely to benefit from it,” he said.
Doctors will in future have to take into account the risk of antimicrobial resistance both for the patient and the wider population before issuing an antibiotic prescription. Hospital doctors will have to take microbial samples from patients suspected of infections before signing a prescription, the Nice guidelines say.
Professor Baker said between 20 and 30 percent of antibiotics currently prescribed by the NHS are unlikely to benefit patients, for example because they are suffering from a throat virus - one of the most common reasons for taking a course of antibiotics.
Many patients have serious misconceptions about antibiotics and the issue of drug-resistant superbugs. Some people believe, for instance, that is they who are at risk of becoming resistant rather than the microbes that infect them, Professor Baker said.
“That often makes it feel that resistance is someone else's problem. The guidelines therefore recommend that prescribers discuss with patients the likely nature of their condition, alternative options such as watchful waiting and/or delayed prescribing and why antimicrobial may not be the best option for them.”
The Independent