GP prescribing of antibiotics in question

Sep 11 2007

GPs prescribing antibiotics often rely on their personal preferences and experience, rather than clinical evidence, says new research launched at the British Pharmaceutical Conference (BPC) in Manchester.

The risk associated with this behaviour is that the drug prescribed may be unnecessary or inappropriate, increasing the potential for antibiotic resistance and adding costs to the Primary Care Trust (PCT), pharmacists at Liverpool's John Moore's University concluded.

Researchers investigated whether GPs were adhering to local PCT guidelines for infection control when prescribing certain specialist and expensive antibiotics (co-amoxiclav and clarithromycin). They also compared results to those of a similar 2005 study. Guidelines say these drugs should only be used as the first-line treatment for very few conditions, but the research found these drugs accounted for 15% of all antibacterials prescribed in the study, and often for conditions not included in the PCT guidelines.

80% of antibiotics prescribed in the UK are in primary care. Doctors find antibiotic therapy difficult because of perceived pressure from patients to prescribe antibiotics that GPs don't believe are clinically justified, set against their worry about failure to treat the small number of cases which lead to serious complications. Following the 2005 research, some education and information support on antibacterial prescribing was provided to GPs. The PCT is also introducing a computer software package that highlights to GPs drug therapy alternatives and potentially better drug therapy choices.

Rachel Aspinall who led the research, said: "There are serious risks associated with prescribing based on preference and experience - it can lead to the chosen drug being inappropriate or completely unnecessary. Reference number: Practice 70 "Inappropriate prescribing can also reduce the effectiveness of antibiotics for patients who may need them in the future, and potentially lead to complete antibiotic resistance. So, it's important GPs are given more support in prescribing. Pharmacists are experts in medicines, and therefore ideally placed to provide support of this kind to ensure all patients receive the best possible healthcare."

Notes to Editors Research investigated aforementioned drugs prescribed within 13 GP practices in a Primary Care Trust (PCT) in the North West of England in December 2006. Information regarding the indication for use and length of the course was retrieved from patient records on the medical information system.

This repeats the method used for the December 2005 data collection, to which the results were then compared. The practices served a population of 87,644 patients and 4,429 prescriptions were issued for an antibacterial drug in December 2006, compared to 4,676 prescriptions in 2005. Of the antibacterial drugs prescribed, 414 were for co-amoxiclav, 142 for clarithromycin and 130 were for any one of the 4-quinolone drugs.

The investigation considered the antibacterials co-amoxiclav, clarithromycin and all drugs belonging to the 4-quinolone class of antibacterials. Reference number: Practice 70 The British Pharmaceutical Conference - entitled "The medicines maze: balancing risks and benefits" - takes place from 10th to 12th September, 2007, at Manchester Central (formerly Manchester International Convention Centre).

The theme of BPC 2007 is reflected throughout the programme, with keynote speeches and workshops addressing crucial technical and professional issues that are facing pharmacy today. The conference will showcase the latest developments in pharmaceutical science and practice research and include discussion and debate led by expert speakers.