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UK GPs 'more likely to give amoxicillin in LRTI'

GPs are more likely to prescribe an antibiotic of ‘least harm' for a lower respiratory tract infection, compared with their European colleagues.

When UK GPs prescribe for an LRTI it is usually amoxicillin, according to a new European study. Elsewhere, macrolides, co-amoxiclav and even fluroquinolones are the most popular antibiotics.

The first results from the five-year £8.2m GRACE study found that about three-quarters of the antibiotics prescribed by GPs in Cardiff and Southampton to patients with acute cough and mean body temperature of 36.8°C were for amoxicillin.

Dr Chris Butler, a GP in south Wales and professor of primary care and public health at Cardiff University, said: ‘A lot of these patients are getting treatment that probably will not benefit them. The UK GPs probably prescribed amoxicillin as an antibiotic that has the potential of causing less harm than the others.'

But he added that GPs should be more reticent about antibiotic prescribing, saying: ‘A considerable number of GPs said the antibiotics they were prescribing would probably not help the patient, but prescribed it anyway.'

In the study about half the patient consultations resulted in antibiotic prescribing, with 12% of the patients being advised to delay taking them for a median of three days.

To avoid giving antibiotic scriptsTo avoid giving antibiotic scripts To avoid giving antibiotic scripts

• Ask the patient what they want – they may have come for a sicknote, or for reassurance that they have nothing serious

• Ask patients how they feel about antibiotics: many will say they don't want to take them ‘unless they really have to'

• Reassure patients they are likely to get better, but may have to put up with symptoms for a further week to 10 days

• Delay prescribing for a week to 10 days

Source: Professor Chris Butler, Professor Paul Little, University of Southampton

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