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Antibiotic guidance on the web: an opportunity for open review
Cliodna A M McNulty1, Shivaun M Gammie, Julius R Weinberg
1Public Health Laboratory, Gloucestershire Royal Hospital, Great Western Road, Gloucester GL1 3NN, UK. jwhiting@phls.nhs.uk
Abstract:
The report The Path of Least Resistance recommended that local antibiotic prescribing information should be based on national guidelines produced under the aegis of the National Institute for Clinical Excellence (NICE). During the period when NICE guidelines on the management of infectious disease are being developed, interim guidelines are needed in primary care. Draft antibiotic guidance developed by Primary Care Groups and the Public Health Laboratory Service was posted on the PHLS website for consultation. An explanatory letter containing the website address was sent to all regional prescribing leads, asking them to draw it to the attention of all those involved in the development of antibiotic guidance. As a result of the numerous comments received from around the UK in the 18 months after posting on the website, 125 substantial changes were made and grading of evidence was added. The electronic production of guidance greatly facilitated the open review process and consequent modifications and reduced printing costs.
Insights
Developing interim antibiotic guidelines for primary care involved public consultation via the internet. This process led to significant revisions and improved evidence grading, enhancing antibiotic stewardship.
Area of Science:
- Public Health
- Infectious Disease Management
- Healthcare Policy
Background:
- National Institute for Clinical Excellence (NICE) guidelines are crucial for antibiotic prescribing.
- Interim guidelines are necessary in primary care during NICE guideline development.
- Previous recommendations emphasized local antibiotic prescribing based on national standards.
Purpose of the Study:
- To develop and refine interim antibiotic guidance for primary care.
- To incorporate public and expert feedback into antibiotic prescribing recommendations.
- To establish an evidence-based framework for antibiotic use in primary care.
Main Methods:
- Draft antibiotic guidance was developed by Primary Care Groups and the Public Health Laboratory Service (PHLS).
- Guidance was posted on the PHLS website for public and professional consultation.
- An explanatory letter was distributed to regional prescribing leads to encourage participation.
Main Results:
- Over 18 months, 125 substantial changes were made to the draft guidance based on received comments.
- Grading of evidence was incorporated into the final guidance.
- Electronic production facilitated an open review process, modifications, and reduced printing costs.
Conclusions:
- Public consultation via the internet is an effective method for refining healthcare guidelines.
- Electronic dissemination and review significantly improve the efficiency and scope of guideline development.
- The revised guidance provides a robust interim framework for antibiotic prescribing in primary care.