NICE: Guideline seeks to reduce antibiotic resistance

NICE published the latest of its antimicrobial prescribing guidelines in February. The guidelines focus on bacterial infections and appropriate antibiotic use, writes Gary Shield. Each guideline topic features a visual summary of the recommendations, a guideline and an evidence review.

The cough (acute) guideline (NG120) sets out an antimicrobial prescribing strategy for acute cough associated with an upper respiratory tract infection or acute bronchitis in adults, young people and children. It aims to limit antibiotic use and reduce antibiotic resistance. There is potential for resource savings if a no antibiotic or a back-up antibiotic prescription strategy is used in this area.

This guideline follows around 20 technologies or guidelines, which were published over the previous two months.

Among the technology appraisals, NICE recommended a pioneering cancer treatment, CART-cell therapy, for people under the age of 25 with leukaemia. The therapy, which involves taking a person’s own immune cells and modifying them to fight their cancer cells, has the potential to be a cure. Under TA554 Tisagenlecleucel for treating relapsed or refractory B-cell acute lymphoblastic leukaemia in people aged up to 25 years, around 25 to 30 people will be eligible for tisagenlecleucel each year in England and a specialised NHS service is being developed to manage access to the new therapy.

Several guidelines were also published including an update to the Chronic obstructive pulmonary disease in over 16s: diagnosis and management guideline (NG115). A new guideline on Renal and ureteric stones: assessment and management (NG118) aims to improve the detection, clearance and prevention of stones, so reducing pain and anxiety, and improving quality of life. The supporting resource impact tools also show how savings of over £2.8m a year for England may be made by implementing the guideline.

In addition, NICE published diagnostic guidance on Tumour profiling tests to guide adjuvant chemotherapy decisions in early breast cancer (DG34). This replaced the NICE diagnostic guidance on gene expression profiling and expanded immunohistochemistry tests for guiding adjuvant chemotherapy decisions in early breast cancer management. Because there is uncertainty around future uptake of the recommended tumour profiling tests, we have created three scenarios for completion at a local level in the resource impact template that supports the guidance.