GP antibiotic prescribing rises 40% in a decade

GPs are 40% more likely to prescribe antibiotics for coughs and colds than a decade ago, a study has found, leading to further calls for doctors to resist patient pressure for unnecessary prescriptions to avoid antimicrobial resistance.

Amoxicillin: GPs are again urged to avoid unnecessary antibiotic prescribing (Photo: SPL)
Amoxicillin: GPs are again urged to avoid unnecessary antibiotic prescribing (Photo: SPL)

Research by Public Health England (PHE) and University College London found the proportion of patients prescribed an antibiotic by their GP for coughs and colds initially fell from 47% in 1995 to 36% in 1999, but has since risen to 51% in 2011.

Experts said there was significant scope for reducing antibiotic prescribing and called on GPs to use the drugs more sparingly to avoid the spread of antimicrobial resistance.

GP leaders said more patient education about the risks of inappropriate antibiotic use was also needed to reduce pressure on GPs to prescribe.

Researchers found a large variation in prescribing rates between practices. Those with the highest rate of prescribing gave antibiotics to two-thirds of patients, compared with just one-third of patients in the lowest-prescribing practices.

Researchers monitored prescribing rates at 537 GP practices to examine adherence to government guidelines on antibiotic use.

These include:

  • No prescribing of antibiotics for simple coughs and colds

  • No prescribing of antibiotics for viral sore throats

  • Limiting prescribing for uncomplicated cystitis to a three-day course of antibiotics

Professor Jeremy Hawker, a consultant epidemiologist at PHE who led the study, said: 'Although it would be inappropriate to say that all cases of coughs and colds or sore throats did not need antibiotics, our study strongly suggests that there is a need to make improvements in antibiotic prescribing.

'Previous research has shown that only 10% of sore throats and 20% of acute sinusitis benefit from antibiotic treatment, but the prescription rates we found were much higher than this.

'The worry is that patients who receive antibiotics when they are not needed run the risk of carrying antibiotic resistant bacteria in their gut. If these bacteria go on to cause an infection, antibiotics will then not work when the patient really does need them.'

'Resist pressure from patients'

Dr Maureen Baker, RCGP chairwoman, said: 'Antibiotics are very effective drugs, as long as they are used appropriately. But we have developed a worrying reliance on them and GPs face enormous pressure to prescribe them, even for minor symptoms which will get better on their own or can be treated effectively with other forms of medication.

'Our patients and the public need to be aware of the risks associated with inappropriate use of antibiotics and how to use them responsibly.

'This study reinforces the message that we issued recently for frontline health professionals to resist pressure from patients for unnecessary prescriptions and explore alternatives to them.'

The data showed 30% of antibiotic prescribing for sore throats in 2011 may have been inappropriate.

Prescribing of a short course of trimethoprim for UTI in women also varied markedly between practices.

A joint statement on antimicrobial resistance released by several royal colleges in June called on GPs to 'get tough' and refuse antibiotics to patients who don't urgently need them.

A WHO report in April warned that the continuing spread of antibiotic resistance could have 'devastating' implications for modern healthcare.

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