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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

MeReC Extra 31

The National Prescribing Centre (NPC) has published MeReC Extra 31 (PDF). It covers the use of antibiotics to prevent serious complications in URTI, the results of a recent study about adoption of guidelines and a discussion of the lack of evidence supporting modern dressings.

The section discussing the use of antibiotics to prevent serious complications in cases of upper respiratory tract infection (URTI) highlights the Clinical Knowledge Summary recommendations that advise against routine use. A recent study is also identified that calculated a number needed to treat of over 4,000 to prevent on serious complication. Clinicians are advised that the decision to prescribe should not be based on a fear of serious complications.

The study about the adoption of guidelines serves as a useful reminder to producers of guidelines to involve stakeholders in the production process and to provide tools to aid implementation. If uptake remains low then an analysis of barriers to implementation and clinician concerns may help identify reasons.

Finally, the discussion of the lack of evidence supporting the use of modern dressings highlights two recent systematic reviews that reveal inadequate research. Many studies are conducted in small numbers of patients and are not properly randomised or blinded. Both reviews failed to find any benefit for more modern dressings over established dressing. Clinicians are encouraged to consider efficacy, safety, cost and patient choice when prescribing dressings.

Action: Clinicians will find this MeReC Extra to be useful and informative. It is of the usual high standard expected from the NPC.

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