The Government has set out a new commitment to mitigate ‘just in case’ antibiotics prescribing in general practice as part of its strategy to tackle antimicrobial resistance.

Several new additions have been made to a revised national action plan that set out how the UK would achieve its ambition of containing and controlling antimicrobial resistance by 2040.

Among the 17 new commitments, the Government said it would ‘explore the extent of “just in case” prescribing in primary care of antimicrobials and the underlying causes’.

This would also involve steps to ‘test and implement interventions to mitigate just in case prescribing’, the update said.

There is also a new commitment to research the impact of Covid-19 on antimicrobial usage, prescribing, stewardship and resistance.

And it outlines a need to review the messaging on antimicrobial stewardship after the pandemic in order to highlight best practice.

In addition, the Government said there was a need for randomised controlled trials to compare length or duration of antibiotic courses in terms of clinical outcome and resistant micro-organisms.

Targets already set out in the current five-year plan which was launched in 2019, include cutting UK use of antibiotics in humans by 15% by 2024 and understanding the proportion of prescriptions which are supported by a diagnostic test or decision support tool.

The Primary Care Respiratory Society recently published a pragmatic guide to support point of care C-reactive protein testing as part of moves to cut antibiotic prescribing.

A study published last year found that delayed antibiotic prescribing is safe and effective for most patients with respiratory tract infections, even those in higher risk groups.

The report, which was published in the BMJ and based on studies of 56,000 people said delayed antibiotic prescribing could be used as a way of reducing antimicrobial resistance, particularly in primary care.

An analysis has previously shown that antibiotic prescribing in general practice fell by 17% between 2014 and 2018 in England but that antibiotic resistant infections had increased.

RCGP chair Professor Martin Marshall told Pulse: ‘Growing resistance to antibiotics is a serious threat to the long-term health of our patients across the country, and worldwide. It is something GPs take seriously, and good progress has been made in reducing antibiotics prescribing.

‘In the UK, GPs and other prescribers are always looking for ways to safely reduce patients’ use of antibiotics. We support any interventions that reduce anti-microbial resistance, and there is evidence that issuing “delayed” prescriptions of antibiotics can help, and it’s important this is considered as clinical advice and guidelines are developed.

‘The College welcomes the Government’s new commitments to the national action plan and the intention to revise it to reflect the impact of Covid-19. We have previously supported such approaches to prescribing and have worked with the UKHSA to develop the TARGET antibiotics toolkit to support GPs and our teams in the appropriate prescribing of antibiotics.’

Taking antibiotics is linked to an increased risk of developing inflammatory bowel disease (IBD), a large population-based cohort study of older adults suggests.

A version of this article was originally published on our sister publication Pulse.