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Action urged to curb antibiotic use

More must be done to curb unnecessary prescribing of antibiotics , experts 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.

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 (PHE) 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 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”.

Lead author Professor Jeremy Hawker, a consultant epidemiologist at PHE, 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.

“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.”

Commenting on the study, Dr 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.

“Our patients and the public need to be aware of the risks associated with inappropriate use of antibiotics and how to use them responsibly.

“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.”

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.

Dame Sally said: “Medical staff are on the front line in our fight against drug resistance but everybody must act now to stop it in its tracks, including patients who put pressure on GPs to prescribe antibiotics.

“Strong action is being taken, a number of royal colleges recently joined forces and asked their members to get behind our antimicrobial resistance strategy. More effective prescribing is a key part of this. Researchers will also be looking to use technology to help doctors diagnose easier and prescribe better in the future.”

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