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Summit pushes rollback of prescribing

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A summit on the growing problem of antibiotic resistance has called for a system of 'rollback' targets antibiotic prescribing to 2010 levels in both primary and secondary care.

The summit, held at the Royal Pharmaceutical Society in London on 6 November, brought together nurses, GPs, pharmacists and other allied health professionals to discuss solutions to antibiotic resistance. Speakers included Isabel Boyer, of the Antimicrobial Resistance Advisory Committee, Rose Gallagher, the RCN's adviser for infection prevention and control, and Chris Butler, professor of primary care at the University of Oxford.

Isabel Boyer spoke about the challenges presented by a lack of public awareness about antibiotic use, stating that 40 per cent of patients believe antibiotics can be used to treat viral illness. She also emphasised the importance of correct antibiotic use in primary care, where 80 per cent of prescribing is done, saying 'over-prescribing in primary care has had the biggest impact on the rise of antibiotic resistance'.

Chris Butler's presentation was entitled 'Making the difference in primary care' and reiterated the need for primary care staff to reduce the amount of antibiotics they prescribe. He said 'Antibiotic prescribing is in a constant state of flux. We have observed large variations in whether and what to prescribe between different primary care settings. It is vital that we have a perpetual process of observation to monitor antibiotic resistance.'

The speakers called for national initiatives, such as recognising antimicrobial stewardship as a quality marker and incorporating antibiotic data into outcome measures, to be implemented across the NHS. The initiatives recognise the importance of reducing the number of antibiotics prescribed to patients by educating them about the optimal use of antibiotics. Over-prescription is a major factor in the rise of antibiotic-resistant bacteria.

PHE has created the TARGET antibiotic toolkit for primary care workers, which is designed to influence the attitudes and cultures that create barriers to optimal antibiotic prescription. The toolkit will provide clinicians and commissioners with training to ensure that the number of antibiotics prescribed unnecessarily is reduced. The toolkit also contains a variety of posters and multimedia aides for general practices, to educate the public about antibiotic resistance.

Rose Gallagher, RCN adviser for infection prevention and control, said: '. 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 needs 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.'

PHE estimates that between 2010 and 2013, there was a six per cent rise in the number of antibiotics prescribed in primary and secondary care.

PHE has created the TARGET antibiotic toolkit for primary care workers, which is designed to influence the attitudes and cultures that create barriers to optimal antibiotic prescription. This can be achieved by raising awareness of the effect of suboptimal antibiotic use. The toolkit will provide clinicians and commissioners with training to ensure that the number of antibiotics prescribed unnecessarily is reduced. The toolkit also contains a variety of posters and multimedia aides for general practices, to help staff educate the public about antibiotic resistance.

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