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

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...

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Main Authors: Paul Little, Lucy Yardley, Martin C Gulliford, Judith Charlton, Lisa McDermott, Michael V Moore, Mark Ashworth, Tjeerd van Staa, Alex Dregan, Gerard McCann
Format: Article
Language:English
Published: BMJ Publishing Group 2014-10-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/4/10/e006245.full
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author Paul Little
Lucy Yardley
Martin C Gulliford
Judith Charlton
Lisa McDermott
Michael V Moore
Mark Ashworth
Tjeerd van Staa
Alex Dregan
Gerard McCann
author_facet Paul Little
Lucy Yardley
Martin C Gulliford
Judith Charlton
Lisa McDermott
Michael V Moore
Mark Ashworth
Tjeerd van Staa
Alex Dregan
Gerard McCann
author_sort Paul Little
collection DOAJ
description 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.
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spelling doaj-art-3be059abd5434ceda69db568604b6d522025-02-01T16:55:09ZengBMJ Publishing GroupBMJ Open2044-60552014-10-0141010.1136/bmjopen-2014-006245Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practicesPaul Little0Lucy Yardley1Martin C Gulliford2Judith Charlton3Lisa McDermott4Michael V Moore5Mark Ashworth6Tjeerd van Staa7Alex Dregan8Gerard McCann91 University of Southampton, Southampton, UKSchool of Psychological Science, University of Bristol, Bristol, Bristol, UKNIHR Biomedical Research Centre at Guy’s and St Thomas’ Hospitals London, London, UKMonash University Accident Research Centre, Monash University, Clayton, Victoria, AustraliaKing`s College London, Primary Care and Public Health Sciences, London, UKprofessor of primary health care researchKing`s College London School of Life Course and Population Sciences, London, UKClinical Practice Research Datalink (CPRD) Division, Medicines and Healthcare Products Regulatory Agency, London, UKKing`s College London, Primary Care and Public Health Sciences, London, UKDepartment of History, York University, York, UKObjectives 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.https://bmjopen.bmj.com/content/4/10/e006245.full
spellingShingle Paul Little
Lucy Yardley
Martin C Gulliford
Judith Charlton
Lisa McDermott
Michael V Moore
Mark Ashworth
Tjeerd van Staa
Alex Dregan
Gerard McCann
Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices
BMJ Open
title Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices
title_full Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices
title_fullStr Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices
title_full_unstemmed Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices
title_short Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices
title_sort continued high rates of antibiotic prescribing to adults with respiratory tract infection survey of 568 uk general practices
url https://bmjopen.bmj.com/content/4/10/e006245.full
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