Antibiotic Prescribing Practices Still Contributing to Resistance

A new study has found that general practitioners (GPs) in the United Kingdom (UK) are still prescribing antibiotics for up to 80% of cases of sore throat, otitis media, upper respiratory tract infections, and sinusitis, despite the fact that official guidance warns against this practice.

Researchers from the Royal Free and University College Medical School (RF&UCMS; London, UK) used the GP research database of consultations and prescriptions, and searched for all consultations between 1998 and 2001 for conditions that might have resulted in an antibiotic prescription. They then identified prescriptions for antibacterial drugs issued by 60 GPs on the same day as a consultation that had identified a possible antibiotic-treatable condition. If an antibacterial was prescribed on the same day as a possible antibiotic indication, it was assumed that the drug had been prescribed for that purpose.

The researchers found that the 10 most common causes of antibacterial prescribing identified were: upper respiratory tract infection, lower respiratory tract infection, sore throat, urinary tract infection, otitis media, conjunctivitis, vague skin infections without a clear diagnosis, sinusitis, otitis externa, and impetigo; despite the fact that guidance recommends against antibiotics for sore throat, otitis media, upper respiratory tract infections, and sinusitis. A survey among patients treated found a surprisingly high proportion of people believe that antibiotics work on viral conditions, and found that a greater knowledge about antibiotics and when they should be used was not associated with a lower likelihood of being prescribed an antibiotic in the last year. The study was published in a special supplement to the August 2007 edition of the Journal of Antimicrobial Chemotherapy.

"Although a third of the public still believe that antibiotics work against coughs and colds, simply getting the public to believe otherwise may not be enough to reduce the level of prescribing. We have shown that those with greater knowledge about antibiotics are no less likely to be prescribed an antibiotic,” said study authors Dr. Irene Petersen and Dr. Andrew C. Hayward of the Centre for Infectious Disease Epidemiology at the University.


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