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Just ‘one in three’ patients expects antibiotics from GP out-of-hours services

Only one-third of patients diagnosed with acute upper respiratory tract infection (URTI) at out-of-hours facilities want antibiotics, according to a new study.

Researchers from the University of Limerick analysed 457 patients with URTI at one primary care out-of-hours (OOH) facility in Ireland and found that only one in three (34%) of respondents expected a course of antibiotics.

Patients mainly wanted further examination (53%), reassurance (51%) and more information (49%), the study found.

This goes against what GPs commonly believe - that patients expect antibiotics - the researchers said.

The study, published in the BMJ, looked at questionnaires given to patients with symptoms of acute URTI before their consultation.

Questions included whether they expected antibiotics or not, their reasons for seeing the GP and what they expected to receive from the GP.

The study’s lead author Ray O’Connor said: ‘Essentially one of the most important factors determining whether a doctor prescribes antibiotics to a patient with URTI is patient expectation, either real or as perceived by the doctor.'

He continued: ‘GPs are very much under the impression that patients attending with URTI, especially private patients and those attending out of hours, expect an antibiotic and so feel pressurised to prescribe them.’

Mr O’Connor said the findings mean 'GPs and other primary care practitioners should feel less pressurised to prescribe antibiotics to patients' and should instead 'focus on using their communication skills to see what the patient really wants and address those issues'.

New Public Health England-commissioned research, released this month, found 80% of antibiotic courses prescribed for respiratory conditions are longer than guidelines advise.

But previous PHE research reported that GP practices with a larger workload are more likely to prescribe antibiotics.

Readers' comments (4)

  • Except that all the complaints are from people who didn't get antibiotics.

    The researchers probably believe that asking men if they beat their wives will give reliable results about the incidence of domestic violence.

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  • Fake news.

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  • What people write on that paper might be total BS- one of the biggest influences is how long they have to sit in the waiting room

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  • doesn't tell you in this study if patients went on to get an antibiotic or not, 50% were on a repeat appt for the same thing and more likely to expect an antibiotic. 40% under 6 years of age. older age groups less likely to attend. this study suggests 66% of patients knew they didn't need an antibiotic but attended anyway. Having done an audit on my own patients attending an OOH provider 2/3 could have waited, self managed or spoken to a pharmacist for advice. total waste of resources

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