Another NHS Long Term Plan theme is the continued targeting of antimicrobial resistance (AMR). The UK-wide AMR five-year plan published in January 2019 focuses on:6,7,8

·       reducing the need for, and unintentional exposure to, antimicrobials

·       optimising antimicrobials usage

·       investing in innovation, supply and access.

Specific targets include:8

·       reducing the number of specific drug-resistant infections in people by 10 per cent by 2025

·       reducing UK antimicrobial use in humans by 15 per cent by 2024

·       being able to report on the percentage of prescriptions supported by a diagnostic test or decision support tool by 2024.

Vaccination will play a key role in tackling AMR. “By promoting herd immunity and reducing the prevalence of infection, [vaccinations] reduce the need for antimicrobials.”8

To support the AMR plan, NICE and Public Health England (PHE) have combined their information on managing common infections in one document. Among the conditions covered are:9

·       upper respiratory tract infections (URTIs) including acute sore throat, influenza, and sinusitis

·       lower respiratory tract infections (LRTIs) including acute exacerbations of COPD and bronchiectasis, acute cough, and pneumonia (community and hospital acquired).

The information reflects the recently published/updated NICE antimicrobial prescribing guidelines for respiratory conditions: 10,11,12,13,14

·       Pneumonia – community-acquired (NG138 – September 2019)

·       Pneumonia – hospital-acquired (NG139 – September 2019)

·       Acute cough (NG120 – February 2019)

·       Bronchiectasis – acute exacerbation (NG117 – December 2018)

·       COPD – acute exacerbation (NG114 – December 2018).