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

Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices
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 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.
e006245-[6pp]
Gulliford, M.C.
443b6214-b206-405a-b13b-b93541e2defc
Dregan, A.
392a61a5-b1a1-4d41-87c3-18e3984b10b2
Moore, M.V.
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Ashworth, M.
a70c436c-8405-4518-806d-1003fd9d5386
van Staa, T.
7e263d59-ecc2-41f2-8b20-3f934d09c2c9
McGann, G.
c13650db-df2a-42f8-aff2-18329ca36837
Charlton, J.
0177b4df-4db7-4de8-b4bd-143b8e3ba169
Yardley, L.
64be42c4-511d-484d-abaa-f8813452a22e
Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
McDermott, L.
5e895229-decd-4a30-8d08-dd9cc5b8f443
Gulliford, M.C.
443b6214-b206-405a-b13b-b93541e2defc
Dregan, A.
392a61a5-b1a1-4d41-87c3-18e3984b10b2
Moore, M.V.
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Ashworth, M.
a70c436c-8405-4518-806d-1003fd9d5386
van Staa, T.
7e263d59-ecc2-41f2-8b20-3f934d09c2c9
McGann, G.
c13650db-df2a-42f8-aff2-18329ca36837
Charlton, J.
0177b4df-4db7-4de8-b4bd-143b8e3ba169
Yardley, L.
64be42c4-511d-484d-abaa-f8813452a22e
Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
McDermott, L.
5e895229-decd-4a30-8d08-dd9cc5b8f443

Gulliford, M.C., Dregan, A., Moore, M.V., Ashworth, M., van Staa, T., McGann, G., Charlton, J., Yardley, L., Little, P. and McDermott, L. (2014) Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices. BMJ Open, 4 (10), e006245-[6pp]. (doi:10.1136/bmjopen-2014-006245). (PMID:25348424)

Record type: Article

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.

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Published date: 2014
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 371958
URI: http://eprints.soton.ac.uk/id/eprint/371958
PURE UUID: dfd9829e-d84e-44bf-96b6-11538413a79a
ORCID for M.V. Moore: ORCID iD orcid.org/0000-0002-5127-4509
ORCID for L. Yardley: ORCID iD orcid.org/0000-0002-3853-883X

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Date deposited: 25 Nov 2014 10:17
Last modified: 15 Mar 2024 03:22

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Contributors

Author: M.C. Gulliford
Author: A. Dregan
Author: M.V. Moore ORCID iD
Author: M. Ashworth
Author: T. van Staa
Author: G. McGann
Author: J. Charlton
Author: L. Yardley ORCID iD
Author: P. Little
Author: L. McDermott

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