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Avoid antibiotics for patients with acute cough

Prescribing antibiotics to patients with acute cough has no impact on recovery time or patient outcomes, new primary care research claims.

Results from a Europe-wide study, which included two research centres in Cardiff and Southampton, found although as many as 70% of patients attending UK practices were prescribed antibiotics for acute cough, there was no significant improvement in their recovery time.

The study, of 3,401 patients presenting with acute cough at general practices in 14 European countries, found UK GPs had by far the highest rate of antibiotic prescribing – at between 60 and 70% overall, and with amoxicillin used in half of patients.

After controlling for difference in case mix, UK patients were up to eight times more likely to receive antibiotics. But despite the widespread prescription of antibiotics, researchers found very little difference in patients' recovery time between patients in different networks.

Professor Chris Butler, professor of primary care medicine at the University of Cardiff and a GP in Averdare, Wales, presented the preliminary results, which are still subject to peer review, at the first European Antibiotics Awareness Day conference in London last week.

He told delegates: ‘Comparing those patients who got antibiotics with those who did not gives a less than 1% difference in the scale of recovery on day seven. Therefore despite the massive difference in prescribing patterns there's almost no difference in patient recovery. It does not meaningfully influence patient outcomes.'

Professor Butler added: ‘This research is important because we know what GPs prescribe locally does drive antibiotic resistance. GPs sometimes think what they prescribe does not make a difference in terms of antibiotic resistance but this research shows it's really worth doing something about it at a local level. Changing prescribing can make and difference in primary care.'

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