Antibiotics for coughs and colds up 40 per cent over decade

THE likelihood of GPs prescribing antibiotics for coughs and colds increased by 40 per cent between 1999 and 2011, according to a new study by scientists at Public Health England and University College London.

This was despite a drop in prescribing rates in previous years.

The study, published in the most recent Journal of Antimicrobial Chemotherapy, monitored trends in prescribing at 537 GP practices and whether antibiotic use agreed with current guidelines.

In terms of actual prescribing rates the proportion of patients offered an antibiotic ‘script’ by their GP for coughs and colds decreased from 47 per cent in 1995 to 36 per cent in 1999 but rose again to 51 per cent by 2011.

Researchers also found substantial variation in prescribing rates between individual practices with some twice as likely to give a prescription for coughs and colds. The 10 per cent of practices with the lowest rates provided prescriptions for antibiotics in less than a third of patients with cough and cold, whereas the 10 per cent highest prescribing practices offered antibiotics to about two-thirds of such patients.

Prescribing for sore throats fell by 15 per cent over four years to 1999 and then stayed broadly stable, but data from 2011 showed that over 30 per cent of patients received an antibiotic that was not recommended in the national guidance.

Prescribing for patients with middle ear infections (otitis media) remained largely unchanged over the study period at 83 per cent of cases, but the research found that 10 per cent of GP practices had prescribed antibiotics to at least 97 per cent of patients who presented with ear infections.

Specific recommendations by the both Department of Health and PHE call for no prescribing of antibiotics for simple coughs and colds and viral sore throats, with limiting prescribing for middle ear infections and uncomplicated cystitis.

Professor Jeremy Hawker, a consultant epidemiologist who led the study, 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 per cent of sore throats and 20 per cent 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."

RCGP chair Dr Maureen Baker 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."