Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices

BMJ Open. 2014 Oct 27;4(10):e006245. doi: 10.1136/bmjopen-2014-006245.

Abstract

Objectives: Overutilisation of antibiotics may contribute to the emergence of antimicrobial drug resistance, a growing international concern. This study aimed to analyse the performance of UK general practices with respect to antibiotic prescribing for respiratory tract infections (RTIs) among young and middle-aged adults.

Setting: Data are reported for 568 UK general practices contributing to the Clinical Practice Research Datalink.

Participants: Participants were adults aged 18-59 years. Consultations were identified for acute upper RTIs including colds, cough, otitis-media, rhino-sinusitis and sore throat.

Primary and secondary outcome measures: For each consultation, we identified whether an antibiotic was prescribed. The proportion of RTI consultations with antibiotics prescribed was estimated.

Results: There were 568 general practices analysed. The median general practice prescribed antibiotics at 54% of RTI consultations. At the highest prescribing 10% of practices, antibiotics were prescribed at 69% of RTI consultations. At the lowest prescribing 10% of practices, antibiotics were prescribed at 39% RTI consultations. The median practice prescribed antibiotics at 38% of consultations for 'colds and upper RTIs', 48% for 'cough and bronchitis', 60% for 'sore throat', 60% for 'otitis-media' and 91% for 'rhino-sinusitis'. The highest prescribing 10% of practices issued antibiotic prescriptions at 72% of consultations for 'colds', 67% for 'cough', 78% for 'sore throat', 90% for 'otitis-media' and 100% for 'rhino-sinusitis'.

Conclusions: Most UK general practices prescribe antibiotics to young and middle-aged adults with respiratory infections at rates that are considerably in excess of what is clinically justified. This will fuel antibiotic resistance.

Keywords: PUBLIC HEALTH.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Common Cold / drug therapy
  • Cough / drug therapy
  • Databases, Factual
  • Female
  • General Practice*
  • Humans
  • Inappropriate Prescribing / statistics & numerical data*
  • Male
  • Middle Aged
  • Otitis Media / drug therapy
  • Pharyngitis / drug therapy
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Respiratory Tract Infections / drug therapy*
  • Retrospective Studies
  • Rhinitis / drug therapy
  • Sinusitis / drug therapy
  • United Kingdom
  • Young Adult

Substances

  • Anti-Bacterial Agents