The pharmacy team needs to be mindful of the potential for antibiotic-related drug-drug interactions. Particularly important in this regard are the interactions concerning the fluoroquinolone and macrolide classes of antibiotic. When screening antibiotic prescriptions the following should be considered:

• Is the prescribed antibiotic the most appropriate for the infection according to guidelines? 

The National Institue for Health and Care Excellence (NICE) has developed national antimicrobial prescribing guidelines and most CCGs also have local antimicrobial guidelines.

• Is the choice, dose, route, frequency and duration appropriate for the patient?

• Is it a delayed prescription? 

Research has shown that a delayed prescribing strategy for some infections reduces antibiotic use compared with immediate antibiotics, without the increased risk of complications, and reduces future expectations for antibiotics. If a patient presents with an antibiotic prescription that is post-dated or is being presented several days or weeks after the date of issue, it is important to determine if the same antibiotic is still required. It may be prudent to contact the prescriber if, for example, symptoms have worsened or there are other warning signs.