10 top tips for talking to patients about anitibiotic prescribing

Dr Cliodna McNulty, Head, Public Health England Primary Care Unit and Rebecca Owens, TARGET Project Manager

16th November 2015 marked the beginning of World Antibiotics Awareness Week, a campaign led by the World Health Organisation. The theme of the campaign, Antibiotics: Handle with Care, reflects the overarching message that antibiotics are a precious resource and should be preserved.

GPs can play a pivotal role in helping to improve awareness and understanding of antimicrobial resistance and appropriate use through effective communication. The Wellcome Trust report, Exploring the consumer perspective on antimicrobial resistance, highlighted that current language around antimicrobial resistance needs to change. The report also suggests that focus of the resistance ‘story’ for the general public needs to shift away from macro factors such as number of deaths to a real and relevant message to patients.

So how can doctors make a difference? Here are 10 tips:

  1. Explain the expected duration of illness so that the patient understands how long they can expect it to last.
  2. Convey that antibiotic resistant infections are carried silently by healthy people and spread very easily between them.
  3. As resistance is increasing always give out safety netting advice – explaining to the patient when they should get help.
  4. Increase your use of back-up antibiotic prescriptions in RTIs with shared decision making about their necessity. These can help reduce antibiotic use by up to 30%.
  5. If antibiotics are necessary, advise the patient to take them as prescribed (lower concentrations at the site of infection encourage resistant bacteria).
  6. Advise the patient to never share antibiotics, and return any leftovers to their pharmacist (use of leftovers is especially common in younger patients).
  7. Advise the patient on strategies for self-care – e.g. have plenty of rest, drink fluids, ask local pharmacist to recommend medicines to help relieve discomfort or pain, use paracetamol or ibuprofen if uncomfortable as a result of fever.
  8. Use a clinical scoring system such as Feverpain when deciding whether to prescribe antibiotics for acute sore throat, which can help reduce unnecessary antibiotics.
  9. You can use an Electronic Prescription Service (EPS) token for back-up antibiotic prescriptions, so patients can come back and collect their prescription from the receptionists. Alternatively use the EPS to postdate the prescription by at least 24 hours, which will prevent patients going next door to a pharmacy to pick it up immediately.
  10. Lastly, use the TARGET Treating your infection leaflet in every consultation. It provides an easy to understand, personalised guide to all of the above points.  It is a great way to facilitate the consultation and has been shown to reduce re-attendance.

Free events - Supporting appropriate antibiotic prescribing in primary care: the TARGET Antibiotics Toolkit

Antibiotic resistance is one of the biggest threats facing us today.  If we don’t tackle antibiotic resistant infections now, it is estimated that they could kill an extra 10 million people across the world each year by 2050.

In 2015, there have been a number of new initiatives to support prescribers in optimising the use of antibiotics and the NICE Guideline 15 provides specific advice to CCGs and practices on steps to take.  Led by the RCGP Clinical Lead for antimicrobial stewardship, Dr Joanna Hayman, and supported by the Public Health England TARGET team, this workshop will equip participants with information and materials to optimise the prescribing of antimicrobials, make a difference locally and potentially reduce consultations in the long term. Please click on the links below for more information:

Manchester – 12 January 2016 
Birmingham – 19 January 2016
Liverpool – 02 February 2016
Luton – 25 February 2016
Newcastle – 09 March 2016

Limited places will be available so please book early. There events are free to attend and lunch and refreshments will be provided.


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