Although prescriptions of antibiotics for respiratory tract infections declined during the 1990s, general practitioners (GPs) still continue to prescribe antibiotics for a high proportion of infections even if the cause of the symptoms are likely to be viral. And this practice is hindering efforts to prevent the spread of antibiotic resistance.
“Many doctors believe that by giving an antibiotic they might be doing some good or at least covering the possibility of a missed diagnosis of significant bacterial disease, with little thought given to the possibility of doing harm,” explains Douglas Fleming, a GP and member of the UK’s Specialist Advisory Committee on Antimicrobial Resistance, a government advisory body.
The study attempted to assess antibiotic prescribing in primary care by use of the General Practice Research Database of consultations and prescriptions. The researchers searched for all consultations between 1998 and 2001 for conditions that might have resulted in an antibiotic prescription.
The ten most common causes of antibacterial prescribing identified in the study were: upper respiratory tract infection, lower respiratory tract infection, sore throat, urinary tract infection, otitis media, conjunctivitis, vague skin infections without a clear diagnosis, sinusitis, otitis externa, and impetigo. The researchers found that for some of these conditions over 80 percent of cases were being treated with antibiotics, despite the fact that guidance recommend against antibiotics for sore throat, otitis media, upper respiratory tract infections, and sinusitis.
“We must not be lulled into a false sense of security believing the prescribing behaviour of GPs has changed. It is preferable to focus interventions on changing behaviour rather than trying to persuade doctors from evidence of the link between resistance and inappropriate prescribing,” comments Dr Fleming.
MEDICA.de; Source: Oxford Journals