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

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

Research output: Contribution to journalArticle (Academic Journal)peer-review

150 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)e006245
JournalBMJ Open
Issue number10
Publication statusPublished - 27 Oct 2014

Bibliographical note

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to


  • Adolescent
  • Adult
  • Anti-Bacterial Agents/therapeutic use
  • Common Cold/drug therapy
  • Cough/drug therapy
  • Databases, Factual
  • Female
  • General Practice
  • Humans
  • Inappropriate Prescribing/statistics & numerical data
  • Male
  • Middle Aged
  • Otitis Media/drug therapy
  • Pharyngitis/drug therapy
  • Practice Patterns, Physicians'/statistics & numerical data
  • Respiratory Tract Infections/drug therapy
  • Retrospective Studies
  • Rhinitis/drug therapy
  • Sinusitis/drug therapy
  • United Kingdom
  • Young Adult


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