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

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

Research output: Contribution to journal › Article (Academic Journal) › peer-review

219 Citations (Scopus)

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.

Original language	English
Pages (from-to)	e006245
Journal	BMJ Open
Volume	4
Issue number	10
DOIs	https://doi.org/10.1136/bmjopen-2014-006245
Publication status	Published - 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 http://group.bmj.com/group/rights-licensing/permissions.

Keywords

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

Access to Document

10.1136/bmjopen-2014-006245

Handle.net

Persistent link

Professor Lucy Yardley
- lucy.yardleybristol.acuk
- Centre for Academic Primary Care
- School of Psychological Science - Professor
Person: Academic , Member

Cite this

@article{eeb6e0396ba640e5bc8ba2e3eee6a603,

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

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 = "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",

author = "Gulliford, \{Martin C\} and Alex Dregan and Moore, \{Michael V\} and Mark Ashworth and Staa, \{Tjeerd van\} and Gerard McCann and Judith Charlton and Lucy Yardley and Paul Little and Lisa McDermott",

note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.",

year = "2014",

month = oct,

day = "27",

doi = "10.1136/bmjopen-2014-006245",

language = "English",

volume = "4",

pages = "e006245",

journal = "BMJ Open",

issn = "2044-6055",

publisher = "BMJ Publishing Group",

number = "10",

}

TY - JOUR

T1 - Continued high rates of antibiotic prescribing to adults with respiratory tract infection

T2 - survey of 568 UK general practices

AU - Gulliford, Martin C

AU - Dregan, Alex

AU - Moore, Michael V

AU - Ashworth, Mark

AU - Staa, Tjeerd van

AU - McCann, Gerard

AU - Charlton, Judith

AU - Yardley, Lucy

AU - Little, Paul

AU - McDermott, Lisa

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

PY - 2014/10/27

Y1 - 2014/10/27

N2 - 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.

AB - 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.

KW - Adolescent

KW - Adult

KW - Anti-Bacterial Agents/therapeutic use

KW - Common Cold/drug therapy

KW - Cough/drug therapy

KW - Databases, Factual

KW - Female

KW - General Practice

KW - Humans

KW - Inappropriate Prescribing/statistics & numerical data

KW - Male

KW - Middle Aged

KW - Otitis Media/drug therapy

KW - Pharyngitis/drug therapy

KW - Practice Patterns, Physicians'/statistics & numerical data

KW - Respiratory Tract Infections/drug therapy

KW - Retrospective Studies

KW - Rhinitis/drug therapy

KW - Sinusitis/drug therapy

KW - United Kingdom

KW - Young Adult

U2 - 10.1136/bmjopen-2014-006245

DO - 10.1136/bmjopen-2014-006245

M3 - Article (Academic Journal)

C2 - 25348424

SN - 2044-6055

VL - 4

SP - e006245

JO - BMJ Open

JF - BMJ Open

IS - 10

ER -

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

Abstract

Bibliographical note

Keywords

Access to Document

Handle.net

Fingerprint

Profiles

Professor Lucy Yardley

Cite this