NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Co-amoxiclav prescribing in GP Practices 2018

Primary Care has made significant progress in both reducing unnecessary antibiotic prescribing, and increasing the use of guideline recommended narrower spectrum antibiotics.  In NHSGGC antibiotic prescribing volume is 12% less than 10 years ago, and is at the lowest level nationally since recording began in 1993.

Co-amoxiclav prescriptions have about halved, but are rising again. This along with concern around the proportion of C. difficile infection that was community acquired, resulted in a recommendation from NHSGGC Antimicrobial Utilisation Committee to review prescribing.

A more detailed report can be found here. The main points are:

Summary - Prescribing Recommendations

  • Co-amoxiclav should be avoided for prophylaxis or long term treatment where possible
  • On the rare occasions where patients are initiated on repeat/longer term antibiotics, they should be classed as being on fixed term with a review period defined at initiation (including out-patient/ discharge recommendations)
  • All guideline* (non 4C) options should be tried first where appropriate
  • Guideline* durations should be adhered to in the majority of cases
  • Persistent symptoms (e.g. urinary or respiratory symptoms) are often not an indication for further antibiotics and alternative causes should be considered and investigated
  • Prescribing for self-limiting infection should be avoided, and patients should continue to be educated on the natural duration of self-limiting illness (in particular cough).  RCGP TARGET resources can be used to support this.

* GGC guidelines are available on StaffNet.


Published 15/03/19. Medicines Update blogs are correct at the time of publication.

We would like to hear what you think of Medicines Update blogs. Please leave us your feedback using this anonymous survey here.