Removal of Trimethoprim from PharmacyPGD

PharmacyPGD run by Red Box Healthcare have now officially removed their trimethoprim PGD from their pharmacy pgd offerings. This is in direct response to the DOH investigation of the NPA and the subsequent removal of their antibiotic PGDs. The exact quote is as follows:

"The Cystitis PGD has been suspended 05/01/2013 to new users as a precautionary measure in response to concerns about Pharmacists supplying antibiotics without prescription. Pharmacists who already have rights to use this PGD may continue to do so until their current rights expire. We will keep the situation under review. If the cystitis PGD becomes available again to new users or for renewal we will inform member Pharmacists by email."

Patientgroupdirection.com, PharmaDoct.co.uk and the National Patient Group Direction Association welcome this decision and believe all private PGD suppliers should follow suit. 

Trimethoprim (Cystitis) PGD Warning

Pharmacy PGDs in the UK need to be created to extremely specific guidelines set out by the MHRA (2010). These guidelines allow for many different medicines to be available via PGDs, however, certain medicines are generally excluded, these include certain controlled drugs and antimicrobials/antibiotics in certain circumstances. The document recommends that PGDs for antibiotics /antimicrobials should only be drawn up if local microbiologist is involved. In general, private PGDs are national guidance, therefore, unless the authorising PGD body directly contacts a local microbiologist in every distinct area in the UK it would be against these recommendations...


"Particular caution should be exercised in any decision to draw up PGDs relating to antibiotics. Microbial resistance is a public health matter of major importance and great care should be taken to ensure that their inclusion in a direction is absolutely necessary and will not jeopardise strategies to combat increasing resistance. A local microbiologist should be involved in drawing up the PGD. The local Drug and Therapeutics Committee or Area Prescribing Committee, where they exist, should ensure that any such directions are consistent with local policies and subject to regular external audit.." - MHRA 2010


The problem here is who would be liable for this. If the MHRA were to step in, the PGD authorising body will probably mention that it is up to the pharmacy that is implementing the PGD to check with a local microbiologist...