Plans to make two antibiotics for treating urinary tract infections available to buy over the counter in the United Kingdom rather than being prescription only are governed by commercial rather than public health concerns, say doctors and pharmacists.

The Medicines and Healthcare Products Regulatory Agency (MHRA) is currently considering reclassifying trimethoprim and nitrofurantoin for the treatment of uncomplicated urinary tract infections, such as cystitis.

The move follows the agency’s approval earlier this month of a similar switch for the antibiotic azithromycin, for the treatment of chlamydia infection.

But members of the British Society of Antimicrobial Chemotherapy oppose the move, the GPs’ magazine Pulse reports (www.pulsetoday.co.uk, 28 Aug, “Fury over decision to make first mainstream antibiotic OTC”). In a letter to health ministers they express concerns that “approvals of this type are determined commercially and not on the basis of medical need.”

doi:10.1136/bmj.a1538