title: Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Data are reported for 568 UK general practices contributing to the Clinical Practice Research Datalink.
  
  
  METHODS
  Participants were adults aged 18-59 years. Consultations were identified for acute upper RTIs including colds, cough, otitis-media, rhino-sinusitis and sore throat.
  
  
  METHODS
  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.
authors.affiliation: King's College London, Primary Care and Public Health Sciences, London, UK.
authors.forename: Martin C
authors.initials: MC
authors.lastname: Gulliford
authors.affiliation: King's College London, Primary Care and Public Health Sciences, London, UK.
authors.forename: Alex
authors.initials: A
authors.lastname: Dregan
authors.affiliation: Department of Primary Care and Population Sciences, University of Southampton, Southampton, UK.
authors.forename: Michael V
authors.initials: MV
authors.lastname: Moore
authors.affiliation: King's College London, Primary Care and Public Health Sciences, London, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Ashworth
authors.affiliation: Clinical Practice Research Datalink (CPRD) Division, Medicines and Healthcare Products Regulatory Agency, London, UK.|Health eResearch Centre, Farr Institute for Health Informatics Research, University of Manchester, London, UK.
authors.forename: Tjeerd van
authors.initials: TV
authors.lastname: Staa
authors.affiliation: Clinical Practice Research Datalink (CPRD) Division, Medicines and Healthcare Products Regulatory Agency, London, UK.
authors.forename: Gerard
authors.initials: G
authors.lastname: McCann
authors.affiliation: King's College London, Primary Care and Public Health Sciences, London, UK.
authors.forename: Judith
authors.initials: J
authors.lastname: Charlton
authors.affiliation: Department of Primary Care and Population Sciences, University of Southampton, Southampton, UK.
authors.forename: Lucy
authors.initials: L
authors.lastname: Yardley
authors.affiliation: Department of Primary Care and Population Sciences, University of Southampton, Southampton, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Little
authors.affiliation: King's College London, Primary Care and Public Health Sciences, London, UK.
authors.forename: Lisa
authors.initials: L
authors.lastname: McDermott
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003139:Common Cold / Q000188:drug therapy; D003371:Cough / Q000188:drug therapy; D016208:Databases, Factual; D005260:Female; D058006:General Practice; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000188:drug therapy; D010612:Pharyngitis / Q000188:drug therapy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D012189:Retrospective Studies; D012220:Rhinitis / Q000188:drug therapy; D012852:Sinusitis / Q000188:drug therapy; D006113:United Kingdom; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: PUBLIC HEALTH