GPs must ask patients if they will take prescribed antibiotics

GPs should openly discuss with patients whether they are likely to adhere to antibiotic treatment, say researchers after finding patients regularly self-medicate using leftover drugs.

Research found unused medicines were taken inappropriately by patients at a later date.
Research found unused medicines were taken inappropriately by patients at a later date.

A study from a Cardiff Uni­­v­ersity team found that as many as 40% of patients took none of their prescribed course of anti­biotics for lower respiratory tract infections.

The researchers questioned whether it was worthwhile prescribing antibiotics in some cases, saying GPs should take into account the likely effect of treatment and whether a patient will adhere.

Lower respiratory tract infe­ction is the most common reason for antibiotic prescribing in primary care. Yet poor adherence reduces treatment benefit, raises anti­biotic resistance and wastes NHS resources.

The researchers said it leaves medicines unused, which are then taken inappropriately by patients at a later date.

To examine levels of adherence in primary care patients, researchers recruited 3,398 patients through 387 GPs.

Data showed that of 1,290 patients who were prescribed antibiotics, only 44.2% fully adhered to the course.

Around 60% did not adhere fully, and within this 41.2% of all patients used none of the drugs. Among 1,226 patients not prescribed antibiotics, 142 (11.6%) took some anyway within the next 28 days.

‘These data will have implications for GPs when considering the use of antibiotics for acute cough/lower respiratory tract infection,’ the researchers said.

GPs need to discuss the likely effect of antibiotic treatment, reasons why patients may not adhere, ways adherence can be improved and ‘in particular, the practice of storing and using leftover antibiotics’, they said.

Research published in February suggested GPs should avoid prescribing amoxicillin for acute sinusitis, after a study found it performed no better than placebo.

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