The National Institute for Health and Care Excellence has issued draft guidelines on the use of antibiotics in pneumonia, to help dispel uncertainties over appropriate treatment and create a more uniform picture of care.

GPs should assess the severity of symptoms and whether people need to be referred to hospital, but for those who can be treated at home, a simple blood test can be used to decide whether antibiotic treatment is required, it said.

This should help to ensure that only those patients who really need antibiotic treatment receive it, thus reducing the danger of resistance.

The draft guideline also calls for hospitals to have care pathways in place that allow severity of pneumonia and required treatment to be assessed within four hours of admission.

"Antibiotics should be offered as soon as possible to people who need it," the Institute noted, but Professor Mark Baker, NICE’s Director of Clinical Practice, stressed "we need to make sure that physicians are absolutely clear on the best way to treat people with pneumonia, whether that’s in hospital or in the community".

Recommends Amitiza for constipation

Meanwhile, NICE has also published draft guidance recommending the use of Sucampo Pharma Europe's Amitiza (lubiprostone) on the NHS in England and Wales as an option for treating chronic idiopathic constipation (CIC). 

The cost regulator said it plans to approve funding for the drug for treating adults with the condition who have tried at least two laxatives from different classes at their highest doses for six months, and for whom invasive treatment for constipation is being considered.

In order to further ensure its cost-effectiveness for the NHS, the Institute has also stipulated that if treatment with the drug is not effective after two weeks, patients should be re-examined and the benefit of continuing treatment reconsidered.   

A 'significant burden'

"Constipation places a significant burden on the UK healthcare system, resulting in over 60,000 hospitalisations annually," commented Ramesh Arasaradnam, University Hospitals Coventry and Warwickshire NHS Trust and University of Warwick.

"For many of the patients who are refractory to standard laxatives, effectively treating with lubiprostone in primary care could negate the need to progress to a secondary or tertiary care referral," he said.