Commentary: Controversies in NICE guidance on antibiotic prescribing for self limiting respiratory tract infections in primary care

doi:10.1136/bmj.a656

Published 23 July 2008, doi:10.1136/bmj.a656
Cite this as: BMJ 2008;337:a656

Practice

Commentary: Controversies in NICE guidance on antibiotic prescribing for self limiting respiratory tract infections in primary care

Christopher C Butler, professor of primary care medicine, head of Department of Primary Care and Public Health¹, Nicholas Francis, Medical Research Council fellow, Department of Primary Care and Public Health¹

¹ Cardiff University, Cardiff CF14 4XN

Correspondence: C C Butler butlercc@Cardiff.ac.uk

doi: 10.1136/bmj.a437

The first 150 words of the full text of this article appear below.

The key message in the new NICE guidance on antibiotic prescribingfor respiratory tract infections is clear—the comprehensivereviews of the existing evidence base confirm that antibiotictreatment does not bring meaningful benefits for most patients.¹For most clinicians this will not be a new message, and indeedmost will agree with the need for change and will already havemade some changes to the way they manage these infections. Butold habits die hard, and we in the United Kingdom still (unjustifiably)prescribe almost double the amount of antibiotics prescribedin, for example, Dutch primary care.² Further progress is hamperedby two main clinical challenges: how to identify accuratelythe few patients who are likely to develop serious illness orwhose symptoms could be meaningfully ameliorated by prompt antibiotictreatment, and how to implement efficiently an evidence basedprescribing decision while responding to patients’ concernsand expectations in the . . . [Full text of this article]

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