A new study published in the BMJ reveals that reducing antibiotic prescribing for respiratory tract infections, such as colds and ear infections, is not linked to an increase in the most serious bacterial complications. The study, funded by the National Institute for Health Research and led by King’s College London researchers, investigated whether reducing antibiotic prescribing for people going to their general practitioner (GP) with respiratory tract infections may have an effect on safety. The study analyzed patient records from 610 UK general practices over 10 years.
General practices with lower rates of antibiotic prescribing for respiratory tract infections did not have higher rates of serious bacterial complications, including meningitis, empyema, brain abscess, Lemierre’s syndrome, or mastoiditis. The results of the analysis showed that practices that prescribed fewer antibiotics had somewhat higher rates of pneumonia and peritonsillar abscess, which is a rare complication of sore throats. Once identified, both of these conditions are treatable with antibiotics.
According to a Science Daily news report, the researchers estimated that if an average-sized GP practice with 7,000 patients reduced its antibiotic prescribing to people with respiratory tract infections by 10%, there could be one extra case of pneumonia each year. Additionally, the researchers estimate that this reduced prescribing could be linked to one extra case of peritonsillar abscess every 10 years. However, the authors note that reducing antibiotic use is likely to reduce the number of people experiencing side effects, which is endured by about 10% of people who take antibiotics.
“Overuse of antibiotics now may result in increasing infections by resistant bacteria in the future. Current treatment recommendations are to avoid antibiotics for self-limiting respiratory infections. Our results suggest that, if antibiotics are not taken, this should carry no increased risk of more serious complications,” says Professor Martin Gulliford, lead author of the study. “General practices prescribing fewer antibiotics may have slightly higher rates of pneumonia and peritonsillar abscess but even a substantial reduction in antibiotic prescribing may be associated with only a small increase in the numbers of cases observed. Both these complications can be readily treated once identified.”
Author of the study Dr Mark Ashworth says, “Patients are recognizing that most upper respiratory infections are viral and virus infections do not respond to antibiotics. Our paper should reassure GPs and patients that rare bacterial complications of respiratory infections are indeed rare. Fortunately, if there are any signs of a complication, the GP can quickly step in and offer an appropriate antibiotic.”
The Science Daily news report indicates that the authors caution that the results represent averages across general practice populations; this study did not evaluate the outcome of prescribing decisions for individual patients.
Source: Science Daily