Family and community medicine options defer prescribing to stop antibiotic resistance

Experts from the Spanish Society of Family and Community Medicine (SEMFYC) work to promote deferred prescribing to address the public health problem of antibiotic resistance. “Delayed prescribing is an easy-to-implement technique in consultations that, in addition to reducing unnecessary antibiotic use, is an educational tool for patients as it helps understand symptomatic treatment of respiratory infections and the development of resistance due to antibiotics. risk of drug resistance. José María Molero, a member of the Infectious Disease Working Group of the Spanish Society of Family and Community Medicine (semFYC), explains: Delayed prescribing of antibiotics is better than immediate prescribing in terms of patient safety and satisfaction. Prescribing is supported by evidence. This type of prescribing involves the family doctor prescribing antibiotics but instructing not to start treatment immediately, but instead providing instructions on when to start treatment depending on the evolution of the infection and symptoms. Regarding deferred prescribing, PRAN Scientific Association The team developed an infographic for use in consultations to educate two patients about the foreseeable evolution of infections and to explain to them the content of deferred prescribing of antibiotics for respiratory infections. “Antibiotics have been shown to improve the use of antibiotics in acute respiratory infections in primary care One of the tools used inappropriately is the use of rapid diagnostic tests at the point of care (measurement of Streptococcus A and blood C-reactive protein), delaying prescriptions and adhering to the recommendations of clinical practice guidelines for the appropriate use of antimicrobials,” Molero said. Therefore, Jose · José María Molero noted that “improving the inappropriate use of antibiotics in primary care, especially for acute respiratory infections, is a priority for the control of antibiotic resistance”, stressing that “overuse and” Inadequate use of antibiotics at community and hospital levels accelerates the emergence and spread of drug-resistant bacteria in the population.” The latter is considered by the World Health Organization (WHO) to be one of the biggest global public health issues facing society. To this end, in the framework of the European Day for the Prudent Use of Antibiotics, celebrated on Saturday 18 November, semFYC calls for the promotion of deferred prescription of antibiotics in primary care health centres. A deferred prescription of antibiotics is when treatment is not started immediately, but is only withdrawn from the pharmacy after a few days when symptoms of the infection worsen. In this sense, “we must remember that it cannot apply to all patients, but only to those who accepted the decision to start an antibiotic regimen,” explains José María Morero. Additionally, the family physician said this strategy “can be used in uncomplicated acute respiratory infections, in which antibiotics are not usually required for treatment, but antibiotics are sometimes prescribed because the physician is unsure of the bacterial source of the infection.” and Benefits of antibiotic use in possible situations: Pharyngitis, acute otitis media, acute bacterial sinusitis, or acute bronchitis in patients with undiagnosed COPD or mild COPD. ” On the contrary, the expert added, “it is not recommended in patients with underlying severe respiratory infections (e.g. pneumonia) or infectious exacerbations of chronic obstructive pulmonary disease (COPD), as well as in patients with severe infections and/or severe complications (mastoiditis, tonsillitis peripheral or retropharyngeal abscess) in cases of acute bronchitis, clinically progressive deterioration, high risk of complications (chronic cardiac, pulmonary, renal, hepatic, neuromuscular comorbidities, immunosuppression, cystic fibrosis) or advanced age (80 years or above))” .