Sir, antibiotic resistance is a global problem and measures to research newer alternatives should be a priority as this poses a significant risk in the future. Each case should be considered carefully before prescribing antibiotics, and based on a correct diagnosis by appropriately trained staff. Some GPs and dentists may feel pressurised by patients who demand antibiotics as they feel it will make them better but clinicians should resist this and say no. There are new NICE guidelines on antibiotics.

It has been mooted that prescribers should be disciplined for over-prescribing which in my opinion is a ridiculous notion as this will be difficult to monitor and enforce. Both the GMC/RCN and GDC have clear standards expected from their registered members. I feel further threats to question clinical judgement could be detrimental and could lead to clinicians being over cautious and possibly doubt their own clinical diagnosis.

In my opinion, guidelines should consider a justification box within the FP10 prescription endorsement section. Recording a justification for giving antibiotics on the FP10 will help with audits on prescribing and could assist the pharmacist if there are issues with the prescription. Having a justification could also alert the pharmacist if they felt they needed to question the prescription, eg for a 'cold' or 'sinusitis' both self-limiting illnesses. It will require both clinicians and pharmacists to liaise closely together. Excellent teamwork and communication will be essential for both clinicians and pharmacists to ensure the best interests of the patients are met.

1. Sheffield