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GPs still prescribe too many antibiotics

Vast majority of doctors said they felt pressure from patients to hand out inappropriate meds

Mark Gould

Tuesday, 19 August 2014

A survey published to coincide with the launch of a £10m prize to find an easy and cost-effective test to confirm bacterial infection reveals that almost half of British GPs have admitted prescribing antibiotics even though they know they will not treat the patient’s condition.

Some 90% of doctors who responded to the questionnaire said they felt pressure from patients to hand out the antibiotics.

The Longitude Prize survey compiled responses from 1,004 GPs across the UK and found 28% have prescribed antibiotics several times a week even when they were not sure if it is medically necessary, and 45% had done so knowing it would not help.

The survey was compiled by experts from Public Health England and University College London who revealed that the number of patients given antibiotics for minor ailments has soared in recent years.

While 36% of patients were given antibiotics for coughs and colds in 1999, by 2011 this figure had soared to 51%, the survey* published in the Journal of Antimicrobial Chemotherapy found.

Seventy per cent of GPs surveyed said they prescribed because they were not sure whether the patient had a viral or bacterial infection, and 24% said it was because of a lack of easy-to-use diagnostic tools.

Dr Rosemary Leonard said she understood the pressures GPs were faced with to prescribe antibiotics when they were not actually necessary. “The more antibiotics taken, the more resistant bacteria come to them,” said Dr Leonard. “Antibiotic resistance is a real issue and more needs to be done to conserve antibiotics for the future.

“Diagnostics play a valuable role in making this happen. Not only can diagnostics help determine the type of infection someone has, they could gather valuable data and aid the global surveillance efforts.”

The Longitude Prize says point-of-care test kits will allow more targeted use of antibiotics, and an overall reduction in misdiagnosis and prescription. Effective and accurate point of care tests will form a vital part of the toolkit for stewardship of antibiotics in the future. This will ensure that the antibiotics we have now will be effective for longer and we can continue to control infections during routine and major procedures.

Tamar Ghosh, who leads the Longitude Prize, said accurate diagnostic tools could help curb the unnecessary use of antibiotics across the globe. “In the next five years the Longitude Prize aims to find a cheap and effective diagnostic tool that can be used anywhere in the world,” she said. “We recognise that stemming the misuse and overuse of antibiotics is just one piece of the jigsaw to slow bacterial resistance to antibiotics.

“Nevertheless it’s an important step when we could be waiting many years for other solutions, including novel alternatives to antibiotics coming to the market.”

* Jeremy I Hawker, et al. Trends in antibiotic prescribing in primary care for clinical syndromes subject to national recommendations to reduce antibiotic resistance, UK 1995–2011: analysis of a large database of primary care consultations. Antimicrobial Chemotherapy. First published online: August 4, 2014. doi: 10.1093/jac/dku291

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