Reductions in antibiotics achievable if guidelines on prescribing duration observed, says NICE

Substantial reductions in antibiotic exposure could be achieved by ensuring that the duration of prescriptions fall in line with national guidance, the National Institute of Health and Care Excellence (NICE) has said.

This recommendation follows the outcome of a large cross-sectional study, published in February 2019
, which found that at least 80% of antibiotic treatments for upper respiratory tract indications, such as acute cough and bronchitis, exceeded the course length recommended by current guidelines.

NICE and Public Health England have jointly published antimicrobial prescribing guidelines for a range of common infection topics, which include recommendations on the choice, dosage and course length of antibiotics, if appropriate.

“The decision about whether to prescribe in these conditions can be complex and requires consideration of the individual’s risk factors,” said Tessa Lewis, a GP and chair of the NICE managing common infections advisory committee.

“However, the decision on what antibiotic course length to use for acute cough should be more straightforward.

“Guidance on length of treatment for cough was consistent for several years prior to 2013. The NICE guideline on antimicrobial stewardship reminds the prescriber to follow prescribing guidelines and use the shortest effective course, and that stewardship teams provide feedback and advice to prescribers who prescribe antimicrobials outside of local guidelines when it is not justified.”

The current goal in the UK is to reduce inappropriate antibiotic prescribing by 50% by 2020/2021.

The UK also has a 20-year vision and 5-year national action plan on antimicrobial resistance for 2019–2024.