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NoECSU Prescribing Newsletter
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Public Health England report highlights combined GP and hospital prescribing of antibiotics up 6% between 2010 and 2013

A report from Public Health England (English surveillance programme for antimicrobial utilisation and resistance (ESPAUR)) published on 10th October found that between 2010 and 2013 there was a 5% increase in the combined antibiotic prescribing of GPs and hospitals.  There was also an increase of 12% in the number of bloodstream infections caused by E.coli with varying levels of resistance to key antibiotics for this infection of between 10 and 19%.

In general, higher rates of resistance were seen in regions with higher rates of prescribing.  The highest levels of GP prescribing were seen in Durham, Darlington and Tees, which were over 40% higher than London (26.5 versus 18.9 defined daily doses per 1000 inhabitants), however the report acknowledged this may be due to access to healthcare in London.

Click here to read more.

European Antibiotics Awareness Day and 'Keep Calm, Antibiotics Arenít always the answer' campaign - call for practice antibiotic champions

European Antibiotics Awareness Day (EAAD) is being held on Tuesday 18th November, as part of the UK 5 year antimicrobial resistance strategy which focuses on antibiotics and sets out actions to slow the development and spread of antimicrobial resistance. 

The ‘Keep Calm, Antibiotics Aren’t Always the Answer’ campaign will also be launched to practices again in November, with posters and leaflets being sent out from 3rd November.  More information on this will follow and will be published on the Medicines Optimisation website.

Click here to read more.

NECS and CPPE conference

NECS Medicines Optimisation and the Centre for Pharmacy Postgraduate Education (CPPE) jointly held a Primary Care Conference in the Marriott Hotel, Gateshead in October 2014 focused on getting evidence into practice.

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Access to Medicines Optimisation eLearning

Access to the antibiotics and repeat dispensing eLearning programmes has changed.  

The updated eLearning programmes can now be accessed through the NECS learning website http://learning.necsu.nhs.uk which will allow you to track your progress, print out and save certificates, download a summary of key points from the eLearning, and leave feedback.

Click here to read more.

Aide memoires for managing the security of prescription forms

NHS Protect have developed three aide memoires for use by prescribers and practice managers, summarising the key points to bear in mind when managing the security of prescription forms.  They also contain details of who should be contacted in the event prescription forms are lost or stolen.

Click here to read more.

Removal of prescribing restrictions for generic sildenafil

On 1st August 2014 legislation came into effect removing prescribing restrictions for sildenafil. 

Prescribing of drugs for erectile dysfunction (ED) was restricted nationally (SLS list) on the grounds of cost to the NHS. 

This restriction for generic sildenafil has now been removed as a consequence of the Viagra® patent expiry and generic sildenafil preparations now being available much more cheaply.

This only applies to prescriptions for generic sildenafil.  Prescribing restrictions are still in place for other ED treatments. 

Click here to read more.

Access to BNF online is changing

From 7 November, you will no longer be able to access the BNF content online from bnf.org. Access will be via the MedicinesComplete website. To continue your access, you must re-register.

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MHRA statement on the misuse of laxatives

Following the BBC Watchdog investigation into the availability of stimulant laxatives in the UK, first broadcast on Thursday 16 October the MHRA have issued a statement recognising the issues and advising of the recent review of patient information for non-prescription laxatives, recommending that stronger warnings should be added emphasising that taking laxatives regularly and for a long time is harmful and they do not aid weight loss.

North East CCGs are the highest prescribers of laxatives in England and Medicines Optimisation teams are working with practices and CCGs to address some of the issues surrounding this locally.

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Changes to Klaricid (clarithromycin) SPC

Use with lovastatin/simvastatin/ticagrelor/ranolazine is contraindicated; and caution with other statins. Reports of hypoglycaemia when used disopyramide, and care needed with oral hypoglycaemics/insulin. Caution when used with ototoxic drugs and CCBs. Angiodema added as ADR.

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Denosumab safety update

Denosumab is associated with a risk of osteonecrosis of the jaw (ONJ) and with a risk of hypocalcaemia. Before starting denosumab treatment, a dental examination and appropriate preventive dentistry are now recommended to reduce the risk of osteonecrosis of the jaw.  Patients should be told to maintain good oral hygiene and report any oral symptoms.

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Changes to labelling of dexamethasone injection

Changes are being made to the labelling of dexamethasone injection. It was formerly referred to as ‘Dexamethasone injection’, but it was in fact dexamethasone phosphate. In future, the dose will be in terms of dexamethasone base.  This therefore means that the doses are different.

Click here for a comparison of dexamethasone phosphate and dexamethasone base doses.

Click here to read more.

Emergency salbutamol inhalers in schools

From 1st October 2014 schools are now allowed to hold emergency salbutamol inhalers.  From this date onwards, schools can buy inhalers and spacers from a pharmaceutical supplier in small quantities provided it is done on an occasional basis and is not for profit.

Click here to read more.

Locality updates
NoESCU
NHS North of England Commissioning Support (NECS)
www.necsu.nhs.uk
necsu.medicinesnewsletter@nhs.net
Tel: 0191 374 4121
2012 All Rights Reserved

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