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Antibiotic use on the rise, despite attempts to curb prescribing

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More must be done to curb unnecessary prescribing of antibiotics, officials have said, after a new study found that the number of patients dished out the drugs for minor ailments has soared in recent years.

Thirty-six per cent of patients were given antibiotics for coughs and colds in 1999 but by 2011 this figure had soared to 51%, researchers found.

This is despite the fact that the government issued guidance in 1998 warning GPs not to issue antibiotics for “simple” coughs and colds.

“Previous research has shown that only 10% of sore throats and 20% of acute sinusitis benefit from antibiotic treatment”

Jeremy Hawker

Health experts from around the globe have recently warned of the ever-growing threat of antibiotic resistance − which has been fuelled by unnecessary prescribing of the drugs.

The new research, by experts at Public Health England and University College London, also found there was “substantial variation” in prescribing among different GP surgeries.

After examining data concerning patients registered with 537 UK GP practices, they found that some practices were twice as likely to give a prescription for coughs and colds as those who dished out the fewest.

In 2011, the best performing practices were giving around 32% of patients antibiotics for coughs and colds compared to 65% in the worst performing GP surgeries.

The study, published online in the Journal of Antimicrobial Chemotherapy, also found significant variation in the proportion of female patients aged 16 to 74 who were given one type of antibiotics for urinary tract infections (UTIs).

During 2011, just 16% of these patients in some practices were prescribed a short course of trimethoprim for a UTI while 70% of those affected by the condition were given the drug in other parts of the country.

The authors said that the “extensive variation” between practices shows ” significant scope to improve prescribing”.

Public Health England

Jeremy Hawker

Lead author Professor Jeremy Hawker, a consultant epidemiologist at Public Health England, said: “Although it would be inappropriate to say that all cases of coughs and colds or sore throats did not need antibiotics, our study strongly suggests that there is a need to make improvements in antibiotic prescribing.

“Previous research has shown that only 10% of sore throats and 20% of acute sinusitis benefit from antibiotic treatment, but the prescription rates we found were much higher than this,” he said.

“The worry is that patients who receive antibiotics when they are not needed run the risk of carrying antibiotic resistant bacteria in their gut. If these bacteria go on to cause an infection, antibiotics will then not work when the patient really does need them,” he added.

Dr Maureen Baker, chair of the Royal College of GPs, said primary care clinicians faced “enormous pressure” to prescribe them, even for minor symptom.

Maureen Baker

Maureen Baker

“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,” she said.

In July, prime minister David Cameron said that resistance to antibiotics was a “very real and worrying threat” as he pledged to put Britain at the forefront of the fight against drug-immune bacteria threatening to send medicine “back to the dark ages”.

Last year, England’s chief medical officer Professor Dame Sally Davies said resistance to antibiotics was one of the greatest threats to modern health.

She stressed that many of the drugs were being used unnecessarily for mild infections which should not be treated with antibiotics, helping to fuel resistance.

  • 1 Comment

Readers' comments (1)

  • Kadiyali Srivatsa

    As a doctor who worked in hospitals in UK, NHS in acute and intensive care for almost thirty years I find this finding very disheartening and uncomfortable.

    My effort to warn healthcare professionals, pharmacuticals and device manufactures about the threat since 1989 has been in vain.

    (1) Criticising the use of pre-printed assessment sheet (1996) to help systemise admission to hospital, (2) Conveying my employer the danger of allowing nurses to prescribe antibiotics (2004) and (3) Publishing my criticism about nurses allowed to work as doctors to offer advice in emergency out of hours (2006) has only resulted in people in power and members of my profession with vested interest ostracising me for defending my profession.

    By giving more importance to "Patient Satisfaction" and ignoring the duty of a doctor is to "Do No Harm", NHS has encouraged antibiotic use. Protocol and guideline based care offer legal protection to nurses and incompetant doctors. By preventing doctors using their skill and experience to reduce antibiotic use, NHS has not only helped micro-organisms but also accelerated the demise od our profession. The result of this callous attitude and alienating doctors who defend their ethics is now obvious.

    Death of 80 (60%) health care staff who contracted Ebola is an early warning because social network of bacteria and virus will soon bring an end to a profession claiming to be "Noble".

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