21 December 2009
Dear Colleague
ANTIBIOTIC AWARENESS
Antibiotic resistance has increased in the
past years to the point where it is now a
major threat to the future effectiveness of
antibiotics. The increase in drug-resistant
bacteria now constitutes a serious risk to
public health.
The contribution of prescribers to the
promotion of antibiotic awareness is
invaluable, as your advice is able to
impact on patients’ perceptions and
attitudes towards their illness and their
perceived need for antibiotics.
Primary care is particularly important in
this context, as primary care accounts for
80-90% of all antibiotic prescriptions.
Studies in Wales and some European
countries have shown that a decrease in
antibiotic prescribing in outpatient care
results in decreased rates of antibiotic
resistance. Therefore, there is a specific
need to promote appropriate use of
antibiotics with primary care patients
throughout Europe. European Antibiotic
Awareness Day – led by the European
Centre for Disease Prevention and
Control, and marked annually on 18
November – focused this year on working
with primary care prescribers to promote
appropriate use of antibiotics and inform
patients about antibiotic resistance and
other risks of improper antibiotic use, such
as side effects.
Some prescriptions are driven by patient
demand and diagnostic uncertainty. The
European Antibiotic Awareness Day
website
http://antibiotic.ecdc.europa.eu
offers
additional
resources
for
communicating antibiotic awareness in
primary care, such as a demonstration of
a patient dialogue method for resisting
inappropriate
patient
demands
for
antibiotics, as well as links to further
reading and ideas for ways to help
patients.
From the Chief Medical
Officer/Chief Scientific
Adviser/Chief Dental Officer/
Chief Pharmaceutical
Advisor
Welsh Assembly
Government
Cathays Park
Cardiff
CF10 3NQ
Llywodraeth Cynulliad
Cymru
Parc Cathays
Caerdydd
CF10 3NQ
CMO(2009)20
CNO(2009)9
CDO(2009)7
CPhA(2009)3
ANTIBIOTIC AWARENESS
Electronic distribution to:
Chief Executive Officers Local Health Boards
Chief Executive Officer Wales NHS Ambulance
Trust
Chief Executive Velindre NHS Trust
Medical Directors Local Health Boards
Nurse Executives Local Health Boards
Chief Executive of Public Health Wales
For onward circulation to:
GPs
Community Pharmacists
General Dental Practitioners
Community Dental Service Managers
Heads of Pharmacy & Medicines Management
Nurse Prescribers
For further information contact:
Dr Sara Hayes
Welsh Assembly Government
Cathays Park
Cardiff
CF10 3NQ
Requests for further copies of this letter
should be addressed to:
DG Operations Team
Health & Social Services Directorate
General
Welsh Assembly Government
Cathays Park,
Cardiff
CF10 3NQ
 Crown copyright 2009
This circular may be freely reproduced by
all those to whom it has been addressed.
Wales’ first report into the use of antibiotics in primary care, which was published
last week (http://howis.wales.nhs.uk/sites3/page.cfm?orgId=457&pid=20791),
reveals that 2.4m prescriptions for antibiotics were dispensed in primary care last
year – almost enough for one course for every person in Wales.
The number of antibiotics prescribed and dispensed to patients has remained
relatively stable during 2007 and 2008, but this followed a 5.8% increase in 2006,
despite growing awareness about the problem of antibiotic resistance.
Taking antibiotics when they are not needed or not taking them correctly will lead
to more bacteria becoming resistant. We therefore need to continue to reduce
our reliance on the prescription of antibiotics for common ailments that could be
managed in other ways. A Welsh Assembly Government leaflet, “Get better
without using antibiotics”, explains the need to get the right treatment for
common illnesses such as colds and coughs without encouraging antibiotic
resistance. This is available at:
http://new.wales.gov.uk/topics/health/protection/communicabledisease/publicatio
ns/antibiotics/?lang=en
Practices and prescribing groups have worked consistently to inform the public
about the appropriate use of antibiotics and to review local data to inform the
dissemination of good practice. This remains very important work and your
continuing support to ensure best practice is greatly valued.
Yours faithfully
DR TONY JEWELL
Chief Medical Officer
ROSEMARY KENNEDY
Chief Nursing Officer for Wales
DR PAUL LANGMAID
Chief Dental Officer
JEREMY SAVAGE
Acting Chief Pharmaceutical Advisor