RESEARCHERS at Dundee University have developed a new strategy for prescribing antibiotics which they claim could save the NHS millions of pounds a year, reduce patient harm and also help combat the rise in antibiotic resistance.
A groundbreaking study by experts at the university’s School of Medicine has shown that the introduction of a new prescribing protocol, involving the introduction of an automatic stop date for hospital patients, could lead to a 40 per cent reduction in antibiotic-related side-effects and reduction of almost 20 per cent in antibiotic use.
Dr Matthew Lloyd, the lead author of the study, said: “Reducing the use of antibiotics is a national priority. We are hoping that health boards, not just not in Britain but across Europe, take these findings on board. It is a method prescribing that is easily picked up and is something that can be done at the point of the prescription of the antibiotic and is not difficult to implement.”
And he stressed: “There is no effect on patient mortality. They are not more likely to die because they are getting less antibiotics and it doesn’t affect their length of stay in hospital.
“We would be reducing the use of antibiotics, reducing the side effects and the problems that come along with antibiotics use whilst they are an in-patient and having no effect on the death rates. That can only be a positive thing and we would like to see this protocol adopted as widely as possible.”
A Dundee university spokesman explained: “The research followed over 500 patients with lower respiratory tract infections during the course of one year. The new prescribing protocol included automatic stop dates, with time limits on prescriptions depending on the severity of an infection, coupled with support from pharmacists to ensure that antibiotics were issued with stop dates that were clearly visible for patients.
“During the first half of the 12-month trial, researchers monitored patients’ current duration of antibiotic use. In the second half, patients receiving antibiotics followed the new prescribing strategy. During both phases of this study, researchers monitored antibiotic side-effects, including new symptoms occurring during the period of antibiotic exposure that were potentially caused by the antibiotics. They also monitored patients’ length of stay in hospital and death rates.”
Dr Lloyd said the new protocol would be applicable in a hospital setting and not in GP surgeries where doctors already prescribe a certain course of limited treatment with antibiotics.
The prescription of antibiotics in hospitals, he said, tended to be “open ended.” Said Dr Lloyd: “Patients continue to receive medication until someone goes and reviews that prescription.But what we did is ensure that, at the point of prescribing, there is an automatic stop date for that course of treatment. It cannot be given unless it has a defined stop date.
“At the moment it is almost open ended. There is no protocol to ensure that each antibiotic has an automatic stop date. Some clinicians are perhaps using longer courses of antibiotics, driven by personal preference. But using this new method reduces the antibiotic use down to the absolute minimum required for that patient.”
He continued: “The threat from growing resistance to antibiotics is increasing, which is in part attributable to inappropriately lengthy courses of antibiotics. Our study aimed to implement a simple system for preventing patients taking antibiotics for longer than they should. The results were promising and found that through prescribing automatic stop dates and working with our multidisciplinary colleagues, we can help prevent this problem and reduce patient harm.”
The findings of the study will be presented at the annual congress of the European Respiratory Society in Barcelona tomorrow (Wednesday)
Professor Francesco Blasi, the society’s’ President, said: “It is crucial that we continue to look at new ways to combat antibiotic resistance. This is a key recommendation of the European Lung White Book, which has been published this week. By implementing strategies, such as this, we can work towards achieving these goals.”