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Call to standardise antibiotic prescribing

Treating respiratory illnesses with antibiotics should be standardised across Europe, according to experts

Treating respiratory illnesses with antibiotics should be standardised across Europe, according to experts in a study published on The British Medical Journal website.

Inappropriate prescribing of antibiotics, particularly for respiratory illnesses, has been blamed for driving the worldwide problem of antibiotic resistance.

"This threat of antibiotic resistance is likely to be more acute as GPs face increasing demands to prescribe antibiotics for acute cough amidst the current global H1N1 flu pandemic," said Professor Herman Goossens of the University of Antwerp, who coordinates the GRACE Network of Excellence.

In the largest study of its kind, researchers from GRACE studied the variation in antibiotic prescribing for acute cough across Europe.

In total 3,402 adults with either a new or worsening cough or a possible lower respiratory tract infection were recruited from 14 primary care research networks in Belgium, England, Finland, Germany, Hungary, Italy, Norway, Poland, Slovakia, Spain, Sweden, The Netherlands and Wales.

Results showed 53 per cent of patients were prescribed antibiotics. However, this ranged from 21 per cent to 90 per cent across the different networks.

In Belgium, Norway and Sweden patients were at least four times less likely to be prescribed antibiotics than the average, whereas doctors in Hungary, Italy, Poland, Slovakia and Wales were twice as likely to prescribe antibiotics.

Variations in prescribing patterns also affected the choice of antibiotic. Amoxicillin was the most common, but ranged from 83 per cent of all prescriptions in England to only 3 per cent in Norway.

Lead researcher, professor Chris Butler of Cardiff University, said: "This international collaborative research showed that the big differences in antibiotic prescribing between countries are not justified on clinical grounds."

The authors concluded that management of acute cough is an issue that is appropriate for standardised international care pathways promoting conservative antibiotic prescribing.

24th June 2009

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