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NICE wants responsible use of antibiotics in pneumonia

Drugs often prescribed to wrong patients

Microbiological cultures

The health watchdog for the NHS in England and Wales has advised healthcare professionals to consider how they prescribe antibiotics for people with pneumonia.

The guidance, published by the National Institute for Health and Care Excellence (NICE), is a response to the number of people with viral infections who are prescribed antibiotic drugs when this form of treatment only works in bacterial infections.

To make matter worse antibiotics are not only ineffective against viral infections, but can lead to side effects as well as growing levels of antimicrobial resistance – a major global public health threat.

The new NICE guidelines recommend that, if a GP is unclear whether a person’s pneumonia is due to a viral or bacterial infection, a patient should undergo a blood test known as the C-reactive protein (CRP) test.

NICE also provides guidance for GPs on how to assess the severity of illness and whether people need to be referred to hospital. The guideline calls for hospitals to have procedures in place that allow diagnosis and treatment of pneumonia to take place within four hours of admission.

In addition HCPs are advised that the length of antibiotic treatment offered should be dependent on the severity of the patient’s illness – those with low severity pneumonia should be offered a shorter five-day course of a single antibiotic instead of the standard seven-day course.

The need to improve diagnostic efforts in bacterial infections was highlighted earlier this year in the winner of the Longitude Prize, a UK innovation prize that was awarded to the development of simple diagnostic test to determine if an infection is caused by bacteria.

NICE has other ongoing efforts to encourage responsible use of antibiotics, announcing in October that it is working on guidance for NHS staff.

Wider efforts to stem the threat of antimicrobial resistance include a UK review to explore the economic issues around the development of new antibiotic drugs.

Also in the UK the charity Antibiotic Research UK was launched earlier this year with the intent to raise money for the further development and discovery of antibiotics.

Kirstie Pickering
4th December 2014
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