Antibiotic guidance on the web: an opportunity for open review

The report The Path of Least Resistance recommended that local antibiotic prescribing information should be based on national guidelines produced under the aegis of the National Institute for Clinical Excellence (NICE). During the period when NICE guidelines on the management of infectious disease are being developed, interim guidelines are needed in primary care. Draft antibiotic guidance developed by Primary Care Groups and the Public Health Laboratory Service was posted on the PHLS website for consultation. An explanatory letter containing the website address was sent to all regional prescribing leads, asking them to draw it to the attention of all those involved in the development of antibiotic guidance. As a result of the numerous comments received from around the UK in the 18 months after posting on the website, 125 substantial changes were made and grading of evidence was added. The electronic production of guidance greatly facilitated the open review process and consequent modifications and reduced printing costs.