A new test could reduce the number of antibiotics prescribed unnecessarily by as many as 10 million each year, according to a report published by a group of prescribing experts.
The report, Straight to the point: Ensuring the rational use of antibiotics in primary care using C-reactive protein testing, states that widespread adoption of the testing could save the NHS as much as £56 million each year, and slow the development of antibiotic resistant bacteria.
The test can be immediately conducted by the nurse or doctor by taking a finger prick blood sample and feeding it into a specially designed machine. This will give a measure of the level of C-reactive proteins in the patient's body. The process takes approximately four minutes. A low level of the proteins means that antibiotics are unlikely to have a worthwhile effect on the patient's ailment.
Evidence from pilot sites in the UK showed that prescribing for respiratory tract infections, which account for half of the antibiotics prescribed in primary care, was reduced by 41.5%. This would have a significant effect on the total number of antibiotics prescribed, as 78.5% of all prescriptions are made in primary care settings.
Chris Butler, professor of primary care at the Nuffield Department of Primary Care Health Sciences at the University of Oxford, said: 'Increasing uptake of point of care C-reactive protein testing into primary care will provide clinicians with additional diagnostic information to help them make crucial prescribing decisions, especially where there is high levels of diagnostic and prognostic doubt.'
Helen Bosley, head of infection prevention and control at Oxford NHS Trust, said that the test has the potential to be used by district nurses to assess the state of patients, and to support them in decisions on whether to refer patients for specialist help. 'There is a strong case to be made for providing district nurses with the capability to carry out these tests. It can aid them to review the health of their patient when they make home visits, and decide whether or not a patient might need to be referred to a general practice or a specialist,' she said.
The report also stressed the need for patients to be educated on when it is appropriate to be prescribed antibiotics. A survey included in the report found that only 3.5% of patients had been denied antibiotics when they had requested them, while 73.5% had been provided with antibiotics after a discussion. A further 23% had been given antibiotics without any discussion about necessity with their nurse prescriber or GP.
Katherine Murphy, the chief executive of the Patients Association, said that education on antibiotics and the difference between bacteria and viruses should begin in primary school.