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1 in 5 antibiotic prescriptions 'inappropriate'

WebMD UK Health News
Medically Reviewed by Dr Sheena Meredith
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27th February 2018 - New research estimates that at least 20% of primary care prescriptions for antibiotics in England are 'inappropriate'.

GP care accounts for around three-quarters of antibiotic prescriptions in the UK so researchers set out to quantify the amount of times GPs prescribed antibiotics when they weren't needed.

The findings have been published by Public Health England (PHE).

Antibiotic resistance

Antibiotics are essential to treat serious bacterial infections but if they are prescribed unnecessarily it can lead to antibiotic resistance – when a strain of bacteria can no longer be killed off by the drug.

PHE already estimates that at least 5,000 deaths a year in England are due to the fact antibiotics no longer work for some infections.

The UK government says by 2020 it wants to reduce inappropriate antibiotic prescribing by half.


Researchers from Public Health England, working with colleagues both within and outside the UK, analysed GP data collected between 1 January 2013 and 31 December 2015. They used prescribing guidelines to define if antibiotics were appropriate and then consulted subject experts to discover what they thought should have been prescribed.

They found that the majority of antibiotic prescriptions in English primary care were for infections of the urinary tract and respiratory tract - including ear, nose, and throat infections. However, in almost a third of all prescriptions no clinical reason was given.

Half of the antibiotics prescribed were penicillins.

The researchers say an antibiotic was prescribed to 41% of people with an uncomplicated cough when experts say it should be just 10%, and in 59% of consultations for a sore throat when ideally it should be 13%. In cases of middle ear inflammation (acute otitis media) in 2-18 year olds antibiotics were prescribed in 92% of cases when experts say it should be 17%.

However, the researchers acknowledge the experts may have ideological or motivational biases that influenced their judgement.


The researchers say prescribing rates varied substantially between GP practices, but there is scope for practices across the country to reduce their rates of prescribing.

Health and social care secretary, Jeremy Hunt, says in a statement: "Drug-resistant infections are one of the biggest threats to modern medicine and inappropriate prescribing of antibiotics is only exacerbating this problem.

"We are leading the world in our response—since 2012, antibiotics prescribing in England is down by 5% and we've invested more than £615 million at home and abroad in research, development and surveillance. But we need to go further and faster otherwise we risk a world where superbugs kill more people a year than cancer and routine operations become too dangerous."

The findings have been published in 5 articles in a supplement to the Journal of Antimicrobial Chemotherapy.

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