NICE publishes antimicrobial prescribing strategy

Author: Jo Carlowe
NICE publishes antimicrobial prescribing strategy

Final guidance has been published this week setting out an antimicrobial prescribing strategy aimed to optimise antibiotic use and reduce antibiotic resistance.

The National Institute for Health and Care Excellence (NICE) and Public Health England published its final antimicrobial prescribing guidance on community-acquired and hospital-acquired pneumonia in adults, young people and children.

Hospital-acquired pneumonia is pneumonia that has developed 48 hours or more after hospital admission and was not incubating at the time of admission. It’s caused by microorganisms that are acquired in hospital, most commonly Streptococcus pneumoniae. Community acquired pneumonia is contracted outside of hospital and usually caused by bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa. There are approximately 220,000 people each year who receive a diagnosis of pneumonia.

The guidance notes that both types of pneumonia can be life-threatening. New recommendations have been added to highlight that antibiotic treatment should be started as soon as possible (no more than four hours after diagnosis and one hour if sepsis is suspected).

Further recommendations include a limited role for levofloxacin. Following a decision earlier this year by the Medicines and Healthcare Products Regulatory Agency to restrict the use of fluoroquinolone antibiotics, the latest guidelines now incorporate this warning.

In December 2014, NICE published guidance on pneumonia in adults: diagnosis and management to help improve assessment and diagnosis of pneumonia. Some of these antimicrobial prescribing recommendations, published today, will update and replace those recommendations.

Between 2013 and 2017, drug-resistant infections in people increased by 35% in England.  Earlier this year, NICE reviewed evidence that found that people, on average, are being prescribed unnecessarily long courses of antibiotics which may lead to antibiotic resistance. NICE have published a suite of antimicrobial guidelines which aim to advise and ensure that antibiotics remain an effective treatment for future generations. The guidance stresses that the shortest antibiotic course effective should be prescribed where possible.