At least 20 percent of all antibiotic prescriptions written in primary care in England are inappropriate, estimates research published by Public Health England (PHE) in the Journal of Antimicrobial Chemotherapy.
Researchers found that the majority of antibiotic prescriptions in English primary care were for infections of the respiratory and urinary tracts but, in almost a third of all prescriptions, no clinical reason was documented.
The research also highlighted substantial variation in antibiotic prescribing rates between GP practices, and that, for most conditions, “substantially higher proportions” of GP consultations led to an antibiotic prescription than is considered appropriate.
Findings showed that an antibiotic was prescribed in 41 percent of all uncomplicated acute cough consultations when experts advocated 10 percent.
A similar trend was seen for bronchitis (actual: 82 percent versus ideal: 13 percent), sore throat (actual: 59 percent versus ideal: 13 percent), rhinosinusitis (actual: 88 percent versus ideal: 11 percent) and acute otitis media in two-18yr olds (actual: 92 percent versus ideal: 17 percent).
“Using antibiotics when you don’t need them threatens their long term effectiveness and we all have a part to play to ensure they continue to help us, our families and communities in the future,” said Professor Paul Cosford, Public Health England’s medical director.
“This publication highlights the role GPs can play and I urge all practices to look at ways they can reduce their inappropriate prescribing levels to help make sure the antibiotics that save lives today can save lives tomorrow.”
Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said the figures “are extremely disappointing” but also cautioned against using them “as an excuse for criticising GPs who are working their hardest to reduce antibiotic prescribing, whilst grappling with countless other workload pressures and a shortage of GPs.
“If GPs do prescribe antibiotics, it is because, in their expert opinion, they are the most appropriate treatment available, given the unique circumstances of the patients before us. However we are still coming under considerable pressure from some patients who need to understand that antibiotics are not a ‘catch all’ for every illness.
“Antimicrobial resistance is now a major global health threat and responsibility for tackling this does not lie solely at the door of GPs – the whole of society must play its part,” she stressed.
Health and care secretary Jeremy Hunt emphasised that the UK is leading the world in its response to the threat of antimicrobial resistance, having invested £615 million at home and abroad in research, development and surveillance and having reduced the overall number of antibiotic prescriptions in England by 5 percent.
“But we need to go further and faster otherwise we risk a world where superbugs kill more people a year than cancer and routine operations become too dangerous,” he added.
The UK government has set an ambition to reduce inappropriate antibiotic prescribing by 50 percent by 2020.
