NICE advises restricted use of antibiotics for COPD

In new guidelines, the Institute recommends that the risk of antimicrobial resistance should be considered when deciding whether antibiotics are needed for treating a flare up of COPD symptoms.

The advice highlights that acute COPD exacerbations can be caused by a range of factors, including viral infections and smoking. Given that only around half are caused by bacterial infections, many exacerbations will not respond to antibiotics.

"The evidence shows that there are limited benefits of using antibiotics for managing acute exacerbations of COPD and that it is important other options are taken into account before antibiotics are prescribed," said Professor Mark Baker, director of the centre for guidelines at NICE.

"The new guideline will help healthcare professionals make responsible prescribing decisions to not only help people manage their condition but also reduce the risk of resistant infections."

The Institute also published a new clinical guideline on diagnosis and management of the condition, which stresses that antibiotics used should only be used to prevent flare-ups in patients most likely to benefit from them.

"For some people who have frequent exacerbations, prophylactic antibiotics can help to reduce the frequency of exacerbations and admissions to hospital. However, the benefits of prophylactic antibiotics needs to be balanced against the potential for more antibiotic resistance," noted Dr Andrew Molyneux, Chair of the COPD update committee.

"With this in mind prophylactic antibiotics should only be offered to carefully selected patients and other treatment options, particularly stopping smoking, should be considered first."

COPD is a common, life-threatening illness affects around 3 million people in the UK, though 2 million are undiagnosed. The condition causes 115,000 admissions to hospital every year.

NICE has issued guidelines advising against blanket use of antibiotics for sore throats and sinus infections, in a bid to cut down on inappropriate prescribing.

The looming threat of AMR is now a high priority for global leaders, with some experts fearing that medicine could ‘return to the dark ages’ - with ten million lives lost every year and $100 trillion in lost productivity by 2050 - if the situation is not addressed.

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