Editorials

Increasing access to medicines

BMJ 2009; 338 doi: http://dx.doi.org/10.1136/bmj.b1397 (Published 07 April 2009) Cite this as: BMJ 2009;338:b1397
  1. Roger Finch, professor1,
  2. Sarah Garner, associate director, research and development 2
  1. 1Division of Microbiology and Infectious Diseases, School of Molecular Medical Sciences, University of Nottingham, Nottingham University Hospitals NHS Trust, Nottingham NG5 1PB
  2. 2National Institute for Health and Clinical Excellence, London WC1V 6NA
  1. r.finch{at}nottingham.ac.uk

    Antimicrobials should be a special case because of the risk of antimicrobial resistance

    Antimicrobials provide huge benefits to individuals and society, but they are unlike other drugs in that they target microorganisms and not pathology related to the host. Microorganisms develop resistance to these drugs, and this can affect agents in the same class and other classes. This phenomenon is a serious threat to public health, and it necessitates wide ranging counter initiatives. These have included efforts to reduce the use of antimicrobials in both animals and humans and to improve prescribing practices.1

    Recent amendments to pharmaceutical policies in the United Kingdom have included giving patients greater access to medicines. Although this has many positive benefits, the policy has sparked debate,2 particularly because three initiatives may inadvertently be countering efforts to control antimicrobial resistance, unless further safeguards are introduced. The first initiative is to increase the range (and therefore number) of trained prescribers to include nurses, pharmacists, podiatrists, and optometrists; the second is to allow patients who meet specific criteria to be given prescription only medicines by a healthcare professional who is not trained to prescribe; and the third initiative, which is of …

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