Infection diseases expert urges GPs to use instant antibiotics test

One of Scotland's top experts on infectious diseases is calling for GPs to be given access to a test that determines immediately if patients need antibiotics.

Electron micrograph of Clostridium difficile bacteria, which is costing NHS Scotland more than £8.5 million a year. Photograph: CDC/Phanie /Rex Features

Professor Alistair Leanord, director of the Scottish Infection Research Network, says a reduction in the number of antibiotics being handed out would bring down instances of C difficile infection in the community.

His comments came after he addressed a European congress on infectious diseases in Vienna yesterday in which he discussed the true impact C difficile has in Scotland.

Professor Leanord said the infection is costing NHS Scotland over £8.5 million per year, puts patients at higher risk of death and amounts to an extra 10,600 hospital beds days a year.

He wants to see a C-Reactive Protein (CRP) test being adopted in doctors surgeries which can tell if someone requires antibiotics in ten minutes. This would lead to a reduction in the number of antibiotics being prescribed – currently about 30 per cent of the Scottish population are given antibiotics at least once a year.

The drugs such as penicillins and clindamycin are a key risk factor in contracting C difficile as they tend to destroy helpful bacteria used to combat the disease.

Professor Leanord said: “One of the tests is called a C-Reactive Protein – that’s a non-specific test that we use as doctors to see if a person is affected or not and needs an antibiotic.

“It’s a useful test and where it has been used in countries like Sweden – we see a 30 per cent drop in prescribing antibiotics – so it clearly has an effect. The issue is that it is still a relatively expensive test costing around £4.

“Catherine Calderwood the Chief Medical Officer is driving discussion with the Scottish population about what actually is realistic in terms of medicine. You can actually spend millions of pound and get diminishing returns – so what is realistic?

“I think moving towards only giving antibiotics to people who need them, that way you don’t have bad things happening to them, would tie in with this.”

Professor Leanord added: “If you come to the doctor’s surgery with a sore throat, you’ll receive either a blood test or a throat test, you’ll go and sit down for ten minutes then someone will come back and tell you it’s a virus and you do not need an antibiotic – take some fluids and pain relief and it will be self-limiting in four to five days.

“This would enable GPs to make an immediate decision as to whether or not a patient requires antibiotics. There will be the occasional grey area with the test but then the GP can give the patient a delayed prescription which they can take to a pharmacy if their condition gets worse. At present 87 per cent of antibiotics are being prescribed in the community by GPs.”