(BRIEF) A recent study by researchers from the Universities of Bristol and Bath, King’s College London, and Utrecht University Medical Center highlights the worrying prevalence of repeated antibiotic prescriptions for respiratory tract infections (RTIs) in the same episode in major care settings. Despite evidence suggesting that repeated prescribing has little benefit, only about 20% of adults and 10% of young people received a second course of antibiotics to decrease RTI, most of which were for the same class of antibiotics. GPs for acute respiratory infections and repeat prescriptions in the past were linked to higher rates of repeated antibiotic use. The authors emphasize the need for antimicrobial stewardship interventions to address this factor and mitigate the dangers of antimicrobial overuse and resistance, especially among vulnerable age groups.
(PRESS RELEASE) BRISTOL, April 8, 2024 — /EuropaWire/ — A new study exploring the use of repeat antibiotic prescriptions for the same episode of respiratory tract infection (RTI), known as repeat “one-episode” prescriptions, in the number one healthcare has found higher rates of their use in England, despite evidence appearing to be of little benefit. The study’s authors, from the universities of Bristol, Bath, King’s College London and Utrecht University Medical Center, call for reducing their use and reducing them. a target for antimicrobial stewardship interventions.
RTIs are one of the most common reasons people seek a GP in the UK. Many RTIs are caused by viruses, and the main existing rules of care propose a strategy of no or delayed prescription of antibiotics in the vast majority of patients. , 54 per cent of RTI consultations in the UK result in an antibiotic prescription, and RTIs account for 60 per cent of antibiotic prescriptions in the number one care globally. As such, IAVs are one of the main drivers of antimicrobial resistance. .
The study, which analysed more than 900,000 episodes of RTI in the clinical records of 530 UK GPs, found that almost 20 per cent of adults and 10 per cent of young people received a second course of antibiotics in the same episode of decreased RTI (lung infection). Nearly a portion (48. 3 percent) of those repeat prescriptions were for the same type of antibiotics.
Previous studies have shown that for most pediatric and adult patients with lung infections, especially those without chronic lung disease, a single course of antibiotics is unlikely to have a clinical benefit, raising concerns about overuse and antibiotic resistance.
Factors relevant with repeat prescribing included common visits to the GP similar to RTIs and repeated antibiotic prescriptions as an episode of RTI. Age was a significant determinant, with young people (< 2 years) and older adults (65 years and older) being the most likely. to get repeat recipes.
Arief Lalmohamed, senior lecturer at Utrecht University Medical Center and lead author of the study, said: “Repeated antibiotic use per episode accounts for a significant proportion of all antibiotics prescribed for ITR. In light of our findings, it is clear that antimicrobial stewardship interventions must go beyond initial antibiotic prescriptions to treat repeated cases of an episode.
Alastair Hay, GP and Professor of Primary Care at the Centre for Academic Primary Care at the University of Bristol, and lead investigator of the study, added: “It turns out that repeated antibiotic treatments have some advantage, given that there is clear evidence that children and adults without chronic lung disease do not benefit from a first course of antibiotics. and NICE recommends five-day courses of antibiotics to minimise respiratory tract infections, such as pneumonia.
Paper
“Repeated Prescribing of Antibiotics in One Episode in Patients With Respiratory Tract Infections: A Population-Based Cohort Study” Arief Lalmohamed et al. in the Journal of Infection
Additional information
1 Little P, Francis NA, Stuart B, O’Reilly G, Thompson N, Becque T, Hay AD, Wang K, Sharland M, Harnden A, Yao G, Raftery J, Zhu S, Little J, Hookham C, Rowley K, Euden J, Harman K, Coenen S, Read RC, Woods C, Butler CC, Faust SN, Leydon G, Wan M, Hood K, Whitehurst J, Richards-Hall S, Smith P, Thomas M, Moore M, Verheij TArray Antibiotics to reduce respiratory tract infections in young people attending the number one care centre in England (ARTIC PC): a double-blind, randomized, placebo-controlled trial. Lancet. 16 October 2021; 398(10309):1417-1426. is what I:10. 1016/S0140-6736(21)01431-8. Published online September 22, 2021. PMID: 34562391; PMCID: PMC8542731.
2 Little P, Stuart B, Moore M, Coenen S, Butler CC, Godycki-Cwirko M, Mierzecki A, Chlabicz S, Torres A, Almirall J, Davies M, Schaberg T, Mölstad S, Blasi F, De Sutter A, Kersnik J, Hupkova H, Touboul P, Hood K, Mullee M, O’Reilly G, Brugman C, Goossens H, Verheij T; GRACE Consortium. Amoxicillin to decrease acute respiratory tract infection in the number one care when pneumonia is not suspected: a randomized placebo-controlled trial in 12 countries. Lancet InfectDis. , February 2013; 13(2):123-9. is what I:10. 1016/S1473-3099(12)70300-6. Published online December 19, 2012. PMID: 23265995.
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