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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.
The susceptibility data for uropathogens …