Article Text

Download PDFPDF

Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices
  1. Martin C Gulliford1,
  2. Alex Dregan1,
  3. Michael V Moore2,
  4. Mark Ashworth1,
  5. Tjeerd van Staa3,4,
  6. Gerard McCann3,
  7. Judith Charlton1,
  8. Lucy Yardley2,
  9. Paul Little2,
  10. Lisa McDermott1
  1. 1King's College London, Primary Care and Public Health Sciences, London, UK
  2. 2Department of Primary Care and Population Sciences, University of Southampton, Southampton, UK
  3. 3Clinical Practice Research Datalink (CPRD) Division, Medicines and Healthcare Products Regulatory Agency, London, UK
  4. 4Health eResearch Centre, Farr Institute for Health Informatics Research, University of Manchester, London, UK
  1. Correspondence to Dr Lisa McDermott; lisa.mcdermott{at}


Objectives 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.

Setting Data are reported for 568 UK general practices contributing to the Clinical Practice Research Datalink.

Participants Participants were adults aged 18–59 years. Consultations were identified for acute upper RTIs including colds, cough, otitis-media, rhino-sinusitis and sore throat.

Primary and secondary outcome measures 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.


This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

View Full Text

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.