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March 2018

20% of antibiotic scrips 'inappropriate'

At least 20% of all antibiotic prescribing in primary care in England is inappropriate, says Public Health England.

Research published in the Journal of Antimicrobial Chemotherapy found that the majority of antibiotic prescriptions in English primary care were for respiratory and urinary tract infections, but for almost a third of all prescriptions, no clinical reason was documented.

Antibiotic prescribing rates varied substantially between GP practices. For most conditions, substantially higher proportions of consultations resulted in an antibiotic prescription than is appropriate, according to expert opinion.

An antibiotic was prescribed in 41% of all uncomplicated acute cough consultations compared to the recommended 10%. For bronchitis, the actual rate of prescribing was 82% compared with an ideal of 13%. For sore throat, antibiotics were prescribed in 59% of cases vs an ideal of 13%. Compared with an ideal of 11%, 88% of patients with rhinosinusitis received an antibiotic, and among children aged 2-18 years with acute otitis media, the actual rate of antibiotic prescribing was 88% vs an ideal rate of 17%.

PHE Medical Director Professor Paul Cosford said the data highlighted the role primary care prescribers can play in addressing antimicrobial resistance. ‘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,’ he said.

Pouwels KB, et al. J Antimicrob Chemother. 2018;73(suppl_2):ii19-ii26. doi: 10.1093/jac/dkx502

March 2018