The recent reclassification of trimethoprim in New Zealand (NZ) will allow women with symptoms of a lower urinary tract infection (UTI) more timely access to an effective treatment. This decision contrasts with the withdrawal of similar nitrofurantoin and trimethoprim applications in the United Kingdom (UK) in 2010. Some differences between the proposed UK reclassifications and the NZ reclassification are apparent. The NZ reclassification allows supply only through ‘accredited’ pharmacists. Additionally, this was a ‘third-party’ reclassification, driven by a pharmacy retail group rather than a pharmaceutical company sponsor.
Concerns about reclassification of antibacterials include increased usage and the subsequent potential for increased resistance. In the NZ model these risks are managed by mandating training of pharmacists and limitations to the supply.
The trimethoprim reclassification in NZ provides a useful opportunity to research the effects of widening availability on the management of the condition and on resistance rates. Such evidence will help inform the debate elsewhere.
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