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Correspondence
Can routine laboratory data guide empirical prescribing?
  1. H Ludlam1,
  2. O Sule2,
  3. M Knapton3,
  4. I Abubakar4
  1. 1Health Protection Agency, Clinical Microbiology and Public Health Laboratory, Addenbrooke’s Hospital, Cambridge CB2 2QW, UK; hugo.ludlam@addenbrookes.nhs.uk
  2. 2Clinical Microbiology Laboratory, Royal Free Hospital, London NW32Q9, UK
  3. 3Cambridge City Primary Care Trust, Heron Court, Ida Darwin, Fulbourn, Cambridgeshire CB1 5EE, UK
  4. 4Communicable Disease Surveillance Centre Eastern, IPH, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

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      Smellie and colleagues have noted large and significant differences in rates of submission of samples for microbiological testing between practices in the south west and north east regions.1 They think that these data indicate that some practices are more selective in the use of the laboratory and speculate that routine laboratory generated antibiotic surveillance data will thus tend to include more complicated cases and overestimate antibiotic resistance. The authors therefore question the validity of using routine laboratory data on antibiotic resistance for primary care based therapeutic guidelines for empirical prescribing, and recommend an enhanced surveillance programme with a standardised approach to testing as a better way of informing such guidelines. We have recently completed such a programme for urinary tract infection (UTI) and can therefore comment on these suggestions.

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