Antibiotic Prescribing

It is well known that we are facing a significant challenge following the rise in antimicrobial resistance (AMR) with the warning from Dame Sally Davies, the Chief Medical Officer of England, that in 25 years more people will die due to antibiotics not working than die from all cancers.

Antibiotic Prescribing

It is well known that we are facing a significant challenge following the rise in antimicrobial resistance (AMR) with the warning from Dame Sally Davies, the Chief Medical Officer of England, that in 25 years more people will die due to antibiotics not working than die from all cancers.

There is a target to reduce antibiotic prescribing by up to 60% if this is to be avoided.

The Design and Learning Centre (DLC) is co-designing solutions that are “Making out-of-hospital care safer for both citizens and the professionals” and the Antibiotic Reduction Challenge is one of these, with the proposal to introduce point-of-care testing (tests that give an instant result, e.g. with finger-prick blood tests) when people feel that they might need antibiotics, especially for minor illnesses.

Trials

Several localities are trialing the use of the CRP (C-reactive protein) to demonstrate whether antibiotics are or not indicated, with the potential of people accessing this test in a variety of situations – doctor surgeries, pharmacies, and the community.

It may be possible for people to access this test by self-referral and potentially reduce workload in the GP surgeries and A&E, whilst improving the citizen experience.

The DLC is bringing together these local trials to see what is the most effective site and what information can be given to the individual. This could:

  • Include what they could do to reduce minor illness such as stopping smoking and increasing exercise
  • Include the limitations of the test – ie whether they have conditions that require clinical assessment
  • Raise the profile of infections such as meningitis and sepsis so that the individual accesses clinical care urgently if indicated.

The DLC has presented the case for antibiotic reduction in several CCGs and has organised one workshop with a further workshop planned.

Evaluation

Once the sites have been evaluated, the DLC will present the findings to the Kent and Medway STP Clinical Board and the Health and Wellbeing Board.

It will review whether we could insist on “No diagnostic – No Antibiotic!”.

Co-implementation

If the project is successful, the DLC will co-implement this innovation locally, if required, as a major initiative to reduce the prescription of antibiotics in minor illness across Kent and Medway “Making out-of-hospital care safer for both citizens and the professionals”.