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The role of evidence in the decline of antibiotic use for common respiratory infections in primary care

The role of evidence in the decline of antibiotic use for common respiratory infections in primary care
The role of evidence in the decline of antibiotic use for common respiratory infections in primary care
Antibiotic prescribing in primary care for common respiratory infections increased steadily until the mid 1990s, when the trend reversed noticeably. During the subsequent decade, antibiotic prescribing reduced by up to one-third in some countries. Explanations for this reduction have focused on a decline in the incidence and severity of common respiratory infections, and on the resulting decrease in the number of patients seeking consultation. We argue that evidence from primary-care research had a central role in changing the practice of antibiotic prescribing, and discuss the concern that has arisen among some physicians around this issue. Targeted reductions in antibiotic prescribing constitute a balancing act between individual and societal concerns, pitting the expected gains in preserving the usefulness of an antibiotic against any given reduction in use. There may be unintended consequences for decreasing antibiotic use beyond a certain point without adequate supporting evidence. A new approach to antibiotic prescribing requires comprehensive research to answer why change is necessary, and how that change can be safely implemented. Future policies must move beyond a ?one size fits all? mindset if public and provider behaviours are expected to become more congruent with the growing research evidence.
1473-3099
749-756
Cosby, Jarold L.
62a4f448-6e27-43ed-8e74-6e9891c8421f
Francis, Nicholas Andrew
9b610883-605c-4fee-871d-defaa86ccf8e
Butler, Christopher Collett
d2f9102c-54c2-4570-be4e-32324c8c8f1d
Cosby, Jarold L.
62a4f448-6e27-43ed-8e74-6e9891c8421f
Francis, Nicholas Andrew
9b610883-605c-4fee-871d-defaa86ccf8e
Butler, Christopher Collett
d2f9102c-54c2-4570-be4e-32324c8c8f1d

Cosby, Jarold L., Francis, Nicholas Andrew and Butler, Christopher Collett (2007) The role of evidence in the decline of antibiotic use for common respiratory infections in primary care. The Lancet Infectious Diseases, 7 (11), 749-756. (doi:10.1016/S1473-3099(07)70263-3).

Record type: Article

Abstract

Antibiotic prescribing in primary care for common respiratory infections increased steadily until the mid 1990s, when the trend reversed noticeably. During the subsequent decade, antibiotic prescribing reduced by up to one-third in some countries. Explanations for this reduction have focused on a decline in the incidence and severity of common respiratory infections, and on the resulting decrease in the number of patients seeking consultation. We argue that evidence from primary-care research had a central role in changing the practice of antibiotic prescribing, and discuss the concern that has arisen among some physicians around this issue. Targeted reductions in antibiotic prescribing constitute a balancing act between individual and societal concerns, pitting the expected gains in preserving the usefulness of an antibiotic against any given reduction in use. There may be unintended consequences for decreasing antibiotic use beyond a certain point without adequate supporting evidence. A new approach to antibiotic prescribing requires comprehensive research to answer why change is necessary, and how that change can be safely implemented. Future policies must move beyond a ?one size fits all? mindset if public and provider behaviours are expected to become more congruent with the growing research evidence.

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e-pub ahead of print date: 22 October 2007

Identifiers

Local EPrints ID: 436263
URI: http://eprints.soton.ac.uk/id/eprint/436263
ISSN: 1473-3099
PURE UUID: 33a6876a-63df-4c62-907f-0c448e395380
ORCID for Nicholas Andrew Francis: ORCID iD orcid.org/0000-0001-8939-7312

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Date deposited: 05 Dec 2019 17:30
Last modified: 17 Mar 2024 03:58

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Contributors

Author: Jarold L. Cosby
Author: Christopher Collett Butler

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