This site is intended for Healthcare Professionals only

Protect and survive

Conditions bookmark icon off

Protect and survive

Antibiotics don’t work on most coughs, colds or cases of flu, yet the number of patients still being prescribed them has risen. What role can pharmacy teams play in helping to protect these valuable drugs from misuse?

The percentage of patients given antibiotics for coughs and colds has soared by 40 per cent over the last 12 years, despite the fact that they don’t work on cough and cold viruses and only help in 10 per cent of sore throat conditions.

These figures are from a study by UCL and Public Health England, which examined more than 500 GP practices between 1999 and 2011. The number of patients prescribed antibiotics for a cough or cold was 36 per cent in 1999, but 51 per cent in 2011. Data from the study also found that more than 30 per cent of these patients received a drug not recommended in national guidance.

Inappropriate prescribing of antibiotics doesn’t just waste money. It also makes it more likely that antibiotics will become resistant to certain bacteria and will therefore cease to work. Even the Prime Minister has acknowledged the dangers. This summer, David Cameron said that we risk “being cast back into the dark ages of medicine” unless we take more action to combat the threat of antibiotic resistance. And chief medical officer Professor Dame Sally Davies said: “Antimicrobial resistance poses a catastrophic threat. If we don’t act now, any one of us could go into hospital in 20 years for minor surgery and die because of an ordinary infection that can’t be treated by antibiotics. And routine operations like hip replacements could be deadly because of the risk of infection.”

People have come to rely on antibiotics as a quick fix for many ailments

The over-prescribing issue

It’s estimated that drug-resistant strains of bacteria are responsible for 5,000 deaths in the UK and 25,000 in Europe every year. Over-use of antibiotics is the main cause of the problem, and it’s especially worrying that the rising trend of prescribing antibiotics continues despite repeated recommendations by the Department of Health and public education campaigns.

“NICE guidance came out in 2008 giving clear direction on treating upper respiratory tract infections, including the use of delayed prescriptions, so we would have expected a decrease,” says Dr Philip Howard, antimicrobial pharmacist and consultant to the Royal Pharmaceutical Society. “In 2012, a toolkit was developed to help GPs with their antibiotic prescribing. Unfortunately, people have come to rely on antibiotics as a quick fix for many ailments. The public need to be aware that the more antibiotics you have, the greater the chance of resistance.”

Customers should drink plenty of liquids when they have a cold

Spread the word

On average, people need to wait less than five minutes to speak to a community pharmacist about winter ailments, but the average wait for a GP appointment is three and a half days, according to research from Pharmacy Voice. “Community pharmacists are the most accessible healthcare professionals,” says the organisation’s chief executive Rob Darracott, “so they have the opportunity to help the public understand how they can treat minor ailments themselves, using OTC medicines to manage the symptoms of their ailments.” Pharmacy teams can help to discourage misuse of antibiotics by giving customers a better understanding of how long a cough, cold or flu should last, so that they wait longer before seeing their GP and use self-help measures and OTC remedies first.

Pharmacy teams can help to discourage misuse of antibiotics by giving customers a better understanding of how long a cough, cold or flu should last, so that they wait longer before seeing their GP and use self-help measures and OTC remedies first. 

“Pharmacy teams can engage with patients who come into the pharmacy and patients who they interact with via home visits and community work, highlighting the varied services and advice available at the local pharmacy,” says Rob. “The pharmacist is also well placed to signpost appropriate individuals to a GP if they think symptoms are possibly more serious.” Antimicrobial pharmacist Dr Howard says that pharmacy teams can do more to educate customers about antibiotic resistance, but it needs to be done correctly. “We don’t want to frighten the public about not taking antibiotics when they are needed,” he says.

Dr Howard believes that pharmacy staff could help to develop the culture of self-care. “Encouraging better hygiene with regular hand washing, especially before eating, not sneezing over people or onto your hands when touching things,” he says. Mimi Lau, director of pharmacy services at Numark, adds: “The message needs to explain that antibiotics must not be prescribed, not because of the cost to the NHS, but because of the huge threat of antibiotic resistance. At the same time, the message needs to inform patients to go to their pharmacy for ways to manage symptoms of coughs and colds – not necessarily to their GP or A&E.”

 

Red flag symptoms

Refer customers to the pharmacist if they have any of the following symptoms:

  • A temperature of 39ºC or above for longer than three days
  • A severe headache with or without vomiting
  • Problems with hearing
  • Confusion or disorientation
  • Coughing blood or blood-stained mucus more than once
  • Chest pain
  • Difficulty swallowing or breathing
  • Swollen lymph nodes in the neck/armpit
  • Severe symptoms in anyone with a chronic medical condition.

Treat yourself better

Pharmacy Voice ran a ‘Treat yourself better without antibiotics’ campaign last year in a bid to help change public perception of antibiotics. But this winter’s campaign will be slightly different. “From the evaluation of last year’s campaign, we concluded that mentioning the thing you’re trying to reduce reliance on can, paradoxically, reinforce its usefulness in the minds of members of the public,” says Rob Darracott, Pharmacy Voice chief executive.

So this year, the message has been improved. “We’ve taken out the ‘without antibiotics’ bit of the strapline and changed it to: ‘Treat yourself better with pharmacist advice’,” Rob explains. “The logo has also been redesigned to make it clearer, so it looks like a speech bubble, and we’re just using green and white colours this year.”

Research carried out for the campaign found that only 21 per cent of adults make use of their local pharmacy for winter ailments, and half of those who visit their GP for common winter ailments do so because they want antibiotics. To support the campaign in pharmacies, Pharmacy Voice and the PAGB have revised the Self Care Advice guides launched last winter to help pharmacy teams deliver consistent advice. Copies are available from: Pharmacy Voice and The NPA.

Self-care tips

Pharmacy Voice also issued the following self-care tips for you to pass on to customers this winter:

  • Wash your hands regularly and properly, especially after touching your nose or mouth and before handling food
  • Always sneeze and cough into tissues
  • Use disposable paper towels to dry your hands
  • Clean surfaces regularly
  • Ensure you and your family have a yearly flu jab
  • Drink plenty of fluids
  • Get plenty of rest and sleep with your head on a raised pillow to relieve a blocked nose
  • Avoid smoking or being around smoky atmospheres.

 

To test your knowledge on this topic, complete the team training learning module.

Copy Link copy link button

Conditions

Share: