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GPs should delay antibiotic prescriptions for sore throat, experts advise

GPs should use delayed antibiotic prescriptions for sore throats as there is little difference in overall symptom control when prescriptions are delayed versus given immediately, experts have advised.

A cohort study found that the level of symptom control between patients with sore throats who were given either delayed or immediate antibiotics was very similar, suggesting that a delayed prescription strategy will help reduce prescription rates without putting patients at risk.

The study, led by researchers from the University of Southampton and the University of Oxford, looked at a group of just over 1600 patients with an acute sore throat who were asked to complete a symptom diary each night until their illness resolved. There was a 61% and 59% rate of poorer overall symptomatic outcome in patients who received immediate or delayed antibiotics respectively, compared with 68% in patients who received no antibiotics.

The authors concluded that since delayed prescription seems to confer a similar symptomatic benefit to immediate prescription, delayed prescription may be an important way to reduce antibiotic uptake.

They said in the paper: ‘Judicious use of antibiotics is an international priority, and there is potential to reduce the uptake of antibiotics through greater use of the delayed prescription technique or through non-prescription. Although adoption of the ‘non-prescribing strategy’ results in the lowest uptake of antibiotics, use of a delayed prescription may be a useful option where current prescribing rates are high or there is greater concern for complications.’

The authors also suggested that since GPs are likely to overestimate patient demand for antibiotics, delayed prescribing may help to counteract any potential bias.

The findings back up current NICE guidelines on treating acute sore throat, which recommend a delayed prescribing strategy and advising and reassuring the patient.

Br J Gen Pr 2017; available online 14th August 


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