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Prescribing of antibiotics decreases 'in spite of GPs'

Much-lauded falls in GP anti-biotic prescribing seen since landmark Government guidelines are due more to lower disease rates than better prescribing practice, major new research shows.

GPs were last month heralded by Government scientists for their efforts to cut

antibiotic prescribing in line with key recommendations in the landmark 1998 Standing Medical Advisory Committee report.

But a new study of 600,000 patients in England and Wales, led by RCGP research head Dr Doug Fleming, has found between 1995 and 2000 the falls in antibiotic prescribing were outweighed by the drop in acute respiratory infections.

The study of 73 practices examined rates of antibiotic prescribing and prevalence of diseases including respiratory and urinary tract infections, shingles and skin infections from Prescription Pricing Authority data and RCGP weekly disease monitoring.

The overall rate of winter respiratory infections fell by 48 per cent from 1995 to 2000, with a 38 per cent fall in summer infections over the same period.

But the corresponding falls in antibiotic prescriptions were 34 per cent and 21 per cent respectively, the study published in this month's British Journal of General Practice showed.

Dr Fleming, a member of the Department of Health's Specialist Advisory Committee on Antimicrobial Resistance and a GP in Birmingham, said: 'The considerable reduction in the incidence of respiratory tract infections between 1995 and 2000 is the main reason for the decline in antibiotic prescribing, rather than changing prescribing thresholds for antibiotics.'

GPC prescribing chair Dr Peter Fellows said GPs were becoming more prudent with antibiotics as they now saw increasing resistance in their own patients. But he added the time pressures on them often made it difficult to avoid prescribing antibiotics.

Dr Fellows, a GP in Lydney, Gloucestershire, said: 'The message is getting across ­ but you're not going to say one day we need more responsible antibiotic prescribing and suddenly you'll get a change.

'It takes more time to explain to patients why they don't need antibiotics.'

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