Prescribing antibiotics in general practice

BMJ 1994;308:1511 (4 June)

Letters

Prescribing antibiotics in general practice

EDITOR, - Conrad M Harris and David C E F Lloyd have tried toaddress an important issue for general practitioners consideringtheir antibiotic prescribing behaviour.¹ Their work, however,is descriptive, and no firm conclusions should be drawn fromit on the optimum treatment of infections (often respiratory)in general practice.

I was intrigued to read that a five day course of phenoxymethylpenicillinwas more common than a seven day course. Can anyone tell mewhy? I have tried to trace the evolution of prescriptions forfive days of phenoxymethylpenicillin and have found referencesto intramuscular treatment during an epidemic of infection withgroup A ß haemolytic streptococci in American servicemen,²and the subsequent use of oral penicillin for 10 days,³ forwhich recommendations persist in the United States.⁴ The reasonfor the final transition from 10 to five days eludes me.