There are fears that national guidelines in the UK to reduce inappropriate prescribing of antibiotics in primary care have failed dramatically in relation to treatment of the common cold, with their use rocketing 42% in this area just 12 years.  

Findings of a study, published in the Journal of Antimicrobial Chemotherapy, show that while the proportion of cough/cold episodes for which antibiotics were prescribed fell from 47% in 1995 to 36% in 1999, they leapt to 51% in 2011. 

A particularly worrying aspect of this is that the rise came after recommendations from the Department of Health in 1998 to curb the use of antibiotics to help fight the spread of antimicrobial resistance. 

The study, by University College London and Public Health England, also found that antibiotic prescribing for sore throats fell from 77% in 1995 to 62% in 1999, but then stayed broadly stable until 2011. However, a significant 31% of patients received treatment with an antibiotic not recommended for use in clinical guidelines. 

After looking at data from 537 GP practices, the researchers concluded that implementation of national guidelines in UK primary care has had “mixed success”, with “prescribing for coughs/colds, both in total and as a proportion of consultations, now being greater than before recommendations were made to reduce it”. 

Maureen Baker, Chair of the Royal College of GPs, said antibiotics “are very effective drugs, as long as they are used appropriately”.

“But we have developed a worrying reliance on them and GPs face enormous pressure to prescribe them, even for minor symptoms which will get better on their own or can be treated effectively with other forms of medication,” she stressed. 

Antibiotics review

Last month, Prime Minister David Cameron announced an antibiotics review looking at the increase in drug-resistant strains, the lack of development of new drugs, and over-use in clinical practice, warning of a return to the dark ages if the issues are not addressed and fast. 

But these findings highlight the enormity of the task to change both the mindset of both doctors and patients. “This study reinforces the message that we issued recently for frontline health professionals to resist pressure from patients for unnecessary prescriptions and explore alternatives to them,” Dr Baker noted.