E-DRUG: The Path of Least Resistance
------------------------------------
Report guides prescribing to the Path of Least Resistance
A report on antimicrobial resistance in relation to clinical
prescribing from a subgroup of the U.K. Department of Health's Standing
Medical Advisory Committee presents recommendations for general
practitioners and calls for a patient education programme and a
national strategy for the surveillance of antimicrobial resistance.
Recommendations presented in The Path of Least Resistance are intended
to constitute the first phase of a national strategy for minimising the
development of antimicrobial resistance.
The report's central recommendation is for a national Campaign on
Antibiotic Treatment in primary care (CAT) on the theme of `four things
you can do to make a difference':
*No prescribing of antibiotics for simple coughs and colds
*No prescribing of antibiotics for viral sore throats
*Limit prescribing for uncomplicated cystitis to three days in women
who are otherwise fit *Limit prescribing for antibiotics over the
telephone to exceptional cases
The CAT initiative in primary care should be supported by a National
Advice to the Public (NAP) campaign, a key feature of which should be
to highlight the benefits of the normal bacterial flora. The Path of
Least Resistance also makes recommendations in several other areas:
prescribing in hospitals, the development of prescribing guidelines,
surveillance of resistance, research, education, hygiene, infection
control and cross infection, veterinary and agricultural use of
antimicrobials, the implications of the report for the pharmaceutical
industry, and international cooperation. The report's authors recognise
that effective surveillance is critical to understanding and controlling
the spread of antimicrobial resistance and recommend that a national
strategy for resistance surveillance should be developed and implemented
swiftly. Evidence based guidelines for prescribing should be developed
and adapted in response to local patterns of resistance derived from
surveillance data. These could be incorporated into computerised decision
support systems in both primary and hospital based care.
The Path of Least Resistance (150 pages, 300 references) is available
from the Communications Unit, PHLS Headquarters, 61 Colindale Avenue,
London NW9 5DF, price �15. A synopsis will be sent to every medical
practitioner in the United Kingdom. The full report, synopsis and an
executive summary are available on the internet.
Reference: Standing Medical Advisory Committee: Sub-Group on
Antimicrobial Resistance. The Path of Least Resistance. London:
Department of Health, 1998. <http://www.open.gov.uk/doh/smac.htm>\.
(From CDR (UK), Vol. 8 / No. 36, Sept 4 reported by Dr. James Chin, CDPC)
----------------------------------
Chris W. Green
Jakarta, Indonesia
Tel: +62-21 846-3029 Fax: +62-21 846-1247
Email: chrisg@rad.net.id
--
Send mail for the `E-Drug' conference to `e-drug@usa.healthnet.org'.
Mail administrative requests to `majordomo@usa.healthnet.org'.
For additional assistance, send mail to: `owner-e-drug@usa.healthnet.org'.