Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Oct 27;4(10):e006245.
doi: 10.1136/bmjopen-2014-006245.

Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices

Martin C Gulliford  1 , Alex Dregan  1 , Michael V Moore  2 , Mark Ashworth  1 , Tjeerd van Staa  3   4 , Gerard McCann  3 , Judith Charlton  1 , Lucy Yardley  2 , Paul Little  2 , Lisa McDermott  1
Affiliations

Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices

Martin C Gulliford et al. BMJ Open. .

Abstract

Objectives: Overutilisation of antibiotics may contribute to the emergence of antimicrobial drug resistance, a growing international concern. This study aimed to analyse the performance of UK general practices with respect to antibiotic prescribing for respiratory tract infections (RTIs) among young and middle-aged adults.

Setting: Data are reported for 568 UK general practices contributing to the Clinical Practice Research Datalink.

Participants: Participants were adults aged 18-59 years. Consultations were identified for acute upper RTIs including colds, cough, otitis-media, rhino-sinusitis and sore throat.

Primary and secondary outcome measures: For each consultation, we identified whether an antibiotic was prescribed. The proportion of RTI consultations with antibiotics prescribed was estimated.

Results: There were 568 general practices analysed. The median general practice prescribed antibiotics at 54% of RTI consultations. At the highest prescribing 10% of practices, antibiotics were prescribed at 69% of RTI consultations. At the lowest prescribing 10% of practices, antibiotics were prescribed at 39% RTI consultations. The median practice prescribed antibiotics at 38% of consultations for 'colds and upper RTIs', 48% for 'cough and bronchitis', 60% for 'sore throat', 60% for 'otitis-media' and 91% for 'rhino-sinusitis'. The highest prescribing 10% of practices issued antibiotic prescriptions at 72% of consultations for 'colds', 67% for 'cough', 78% for 'sore throat', 90% for 'otitis-media' and 100% for 'rhino-sinusitis'.

Conclusions: Most UK general practices prescribe antibiotics to young and middle-aged adults with respiratory infections at rates that are considerably in excess of what is clinically justified. This will fuel antibiotic resistance.

Keywords: PUBLIC HEALTH.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow chart showing selection of general practices and participants ( RTI, respiratory tract infection; CPRD, Clinical Practice Research Datalink).
Figure 2
Figure 2
Distribution for per cent of respiratory tract infection consultations with antibiotics prescribed for adults aged 18–59 years at 568 UK general practices.
See this image and copyright information in PMC

References

    1. Chief Medical Officer. Annual Report of the Chief Medical Officer. Volume 2, 2011. Infections and the rise of antimicrobial resistance. London: Department of Health, 2013
    1. Little P, Gould C, Williamson I, et al. . Reattendance and complications in a randomised trial of prescribing strategies for sore throat: the medicalising effect of prescribing antibiotics. BMJ 1997;315:350–2 - PMC - PubMed
    1. Glasziou PP, Del Mar CB, Sanders SL, et al. . Antibiotics for acute otitis media in children. Cochrane Database Syst Rev 2004;(1):CD000219. - PubMed
    1. National Institute for Health and Care Excellence. Prescribing of antibiotics for self-limiting respiratory tract infections in adults and children in primary care. Final scope 130907. London: National Institute for Health and Care Excellence, 2008 - PubMed
    1. Ashworth M, Latinovic R, Charlton J, et al. . Why has antibiotic prescribing for respiratory illness declined in primary care? A longitudinal study using the General Practice Research Database. J Public Health (Oxf) 2004;26:268–74 - PubMed

Publication types

MeSH terms

Substances