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Nurses make up bulk of independent prescribers

Increasing numbers of primary care nurses are prescribing independently

Primary care nurses are key to the progression of antimicrobial stewardship efforts as increasing numbers are prescribing independently, according to a new study.

Cardiff University’s Professor Molly Courtenay and colleagues have put together a study for the Journal of Antimicrobial Therapy measuring the patterns of antibiotics dispensed as prescriptions from non-medical prescribers (NMPs) in England from 2011-2015, which include nurses prescribing independently.

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The study found that, between January 2011 and December 2015, the number of NMPs rose by 38.5% from 21,545 to 29,836. Most of these prescribers were nurses, making up 88% in 2011 and rising to 89.8% in 2015.

Antibiotics made up a large portion of NMP prescriptions with nurses issuing 12,077,107 antibiotic prescriptions out of a total of 98,577,980 NMP prescriptions from the five-year period. Overall, there was a total of 186,323,947 antibiotic prescriptions in England.

‘With the numbers of NMPs being set to rise further, they form an important group to involve in antimicrobial stewardship efforts,’ Professor Courtenay said. ‘Our work suggests that nurse prescribers are following government recommendations for self-limiting minor infections.

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‘Given their increasing contributory influence on total antibiotic prescribing in primary care, it is important that this group are involved in antimicrobial stewardship. Further research is required to establish a better understanding of the influences on the prescribing behaviour of these prescribers.’

The most commonly prescribed antibiotics by nurses were penicillin, sulphonamides, trimethoprim, macrolides, tetracyclines and nitrofurantoin.