NICE calls to limit antibiotic use in COPD over antimicrobial resistance fears

NICE have published a draft antimicrobial prescribing guide recommending that healthcare professionals should consider the risk of antimicrobial resistance when deciding whether to prescribe antibiotics in treating chronic obstructive pulmonary disease (COPD).

The draft guide recommends that antibiotics should be offered to people who have a severe flare up of symptoms, also known as a severe acute exacerbation.  However, doctors are encouraged to consider a variety of factors including severity of symptoms, previous exacerbation history, the risk of developing complications and the risk of antimicrobial resistance when deciding to prescribe antimicrobial drugs in less severe cases.

The draft guidance notes that while acute exacerbations of COPD can be caused by a range of factors including viral infections and smoking, only around half of all cases are caused by bacterial infections. As such, many exacerbations will not respond to the use of antibiotics.

Professor Mark Baker, Director of the Centre for Guidelines at NICE said: "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.

The term COPD refers to a set of several conditions that give rise to breathing difficulties in sufferers. COPD affects approximately three million people in the UK, with two million of those who suffer from the condition remaining undiagnosed.

As expanded upon by Dr Andrew Molyneux, Chair of the COPD update committee: "COPD is a common and life-threatening illness, causing 115,000 admissions to hospital every year. 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."

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