Medics have called for action to curb the use of antibiotics to prevent resistance to the treatment

Experts say more must be done to curb unnecessary prescribing of antibiotics, after a study found the number of patients given the drugs has increased

Dr George Rae
Dr George Rae

Historically  antibiotics have been seen as wonder drugs for patients as they can treat and prevent a whole host of bacterial infections.

But resistance to the medication is one of the greatest threats to modern health as more and more people are being given the treatment.

The World Health Organisation has previously warned of “a doomsday scenario of a world without antibiotics,” in which antibiotic resistance will turn common infections into incurable killers and make routine surgeries a high-risk gamble.

Now health experts are insisting that more must be done to curb unnecessary prescribing of antibiotics, after a new study found that the number of patients given the drugs for minor ailments has increased significantly in recent years.

Researchers found that 36% of patients were given antibiotics for coughs and colds in 1999 but by 2011 this figure had soared to 51%.

This is despite the fact that the Government issued guidance in 1998 warning GPs not to issue antibiotics for “simple” coughs and colds.

Medics in the North East say it is important that restraint is exercised in prescribing antibiotics for patients so that the treatment can continue to save lives.

Dr Dan Cowie, a GP in Gateshead and executive member of NHS Gateshead Clinical Commissioning Group said: “We know that antibiotics aren’t always the answer but they can save lives. As GPs we need to be making sure that we use them wisely, as antibiotics only fight infections caused by bacteria.

“Bacteria can adapt and find ways to survive the effects of antibiotics. This means that they become ‘antibiotic resistant’ so that antibiotics no longer work.

“The more antibiotics are used, the more resistant bacteria become to it, so it’s important that they are only prescribe this when absolutely necessary and it’s going to be of benefit to patients.

“We need to make sure that we are using antibiotics in the right way, to slow down the resistance and make sure these life-saving medicines remain effective for us and future generations.”

Dr Dan Cowie, a GP in Gateshead and executive member of NHS Gateshead Clinical Commissioning Group
Dr Dan Cowie, a GP in Gateshead and executive member of NHS Gateshead Clinical Commissioning Group

The new research, by experts at Public Health England (PHE) and University College London, found there was “substantial variation” in prescribing among different GP surgeries.

After examining data concerning patients registered with 537 GP practices in the UK, they found that some practices were twice as likely to give a prescription for coughs and colds as those who dished out the fewest.

In 2011, the best performing practices were giving around 32% of patients antibiotics for coughs and colds compared to 65% in the worst performing GP surgeries.

Dr George Rae, chairman of the North East British Medical Association said: “When looking at antibiotic prescribing and drug resistance we have got to realise that antibiotics arealso unfortunately available readily across the counter in Europe.

“Emerging resistance is certainly a huge concern and it is very important that, whilst professionals are taking this message on board, there is also a patient understanding of when antibiotics should be and when they should not be used.

“Undoubtedly minor ailments such as colds which are caused by viruses are the typical situation where antibiotic use is totally inappropriate.”

The new study, published in the Journal of Antimicrobial Chemotherapy, also found significant variation in the proportion of female patients aged 16 to 74 who were given one type of antibiotics for urinary tract infections (UTIs).

During 2011, just 16% of these patients in some practices were prescribed a short course of trimethoprim for a UTI while 70% of those affected by the condition were given the drug in other parts of the country.

The authors of the research said that the “extensive variation” between practices shows “ significant scope to improve prescribing”.

Lead author Prof Jeremy Hawker, a consultant epidemiologist at PHE, said: “Although it would be inappropriate to say that all cases of coughs and colds or sore throats did not need antibiotics, our study strongly suggests that there is a need to make improvements in antibiotic prescribing.

“Previous research has shown that only 10% of sore throats and 20% of acute sinusitis benefit from antibiotic treatment, but the prescription rates we found were much higher than this.

“The worry is that patients who receive antibiotics when they are not needed run the risk of carrying antibiotic resistant bacteria in their gut. If these bacteria go on to cause an infection, antibiotics will then not work when the patient really does need them.”

Antibiotics are medications that are used to treat and, at times prevent, a variety of bacterial infections. There are hundreds of different types of antibiotics and the treatment works by fighting against bacterial infections but they don’t do any good against viral infections.

Often it can be patients who ask their GP for an antibiotic prescription as they consider it an important treatment and put pressure on their doctor.

Dr Maureen Baker, chair of the Royal College of GPs, said: “Antibiotics are very effective drugs, as long as they are used appropriately. But we have developed a worrying reliance on them and GPs face enormous pressure to prescribe them, even for minor symptoms which will get better on their own or can be treated effectively with other forms of medication.

“Our patients and the public need to be aware of the risks associated with inappropriate use of antibiotics and how to use them responsibly.

“This study reinforces the message that we issued recently for frontline health professionals to resist pressure from patients for unnecessary prescriptions and explore alternatives to them.”

In July, Prime Minister David Cameron said that resistance to antibiotics was a “very real and worrying threat” as he pledged to put Britain at the forefront of the fight against drug-immune bacteria threatening to send medicine “back to the dark ages”.

Last year, England’s chief medical officer Professor Dame Sally Davies said resistance to antibiotics was one of the greatest threats to modern health. She stressed that many of the drugs were being used unnecessarily for mild infections which should not be treated with antibiotics, helping to fuel resistance.

Dame Sally said: “Medical staff are on the front line in our fight against drug resistance but everybody must act now to stop it in its tracks, including patients who put pressure on GPs to prescribe antibiotics.

“Strong action is being taken, a number of royal colleges recently joined forces and asked their members to get behind our antimicrobial resistance strategy. More effective prescribing is a key part of this. Researchers will also be looking to use technology to help doctors diagnose easier and prescribe better in the future.”

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