NICE urges alternative to antibiotic scrips for RTIs

Clinicians should use alternative prescribing strategies to giving out antibiotic scrips for respiratory tract infections (RTIs) in both children and adults, says NICE.

In a short clinical guideline issued today, NICE advises staff in GP practices, walk-in centres and emergency settings to avoid giving antibiotic scrips for routine RTIs or offer delayed prescribing.

Every year, one in four people visit their GP with an RTI. Scrips for RTIs make up 60 per cent of all antibiotic prescribing in general practice. This is despite evidence showing that antibiotics have limited effectiveness in treating a large proportion of RTIs in adults and children.

Immediate antibiotic prescribing is only needed for under-twos with bilateral acute otitis media, children with otorrhoea along with acute otitis media, and patients with an acute sore throat or tonsillitis when three or more Centor criteria are present.

‘Management of RTIs in the past concentrated on advising prompt antibiotic treatment,’ said Professor Paul Little, who led the guideline development group.

‘However, as rates of major complications are much less common in modern developed countries, so the evidence of symptomatic benefit should be strong to justify prescribing antibiotics so that we are not needlessly exposing patients to side effects.’

NICE antibiotic guidance

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