GPs feel pressurised to prescribe unnecessary antibiotics, survey findsBMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5238 (Published 20 August 2014) Cite this as: BMJ 2014;349:g5238
Many GPs feel under pressure to prescribe antibiotics even when they may not be the correct treatment, and some patients continue to expect antibiotics as a matter of right, two parallel surveys from the Longitude Prize charity have found.
The surveys of more than 1000 GPs and a similar number of patients were commissioned by Nesta, the organisation behind the £10m (€12.5m; $16.6m) Longitude Prize, which the public voted to award to finding smarter ways of using existing antibiotics, in the face of growing resistance and a dearth of new types.1
The survey of GPs found that 55% felt under pressure—mainly from patients—to prescribe antibiotics, even if they were not sure that they were necessary, and 44% admitted that they had prescribed antibiotics to get a patient to leave the surgery. A similar proportion (45%) had prescribed antibiotics for a viral infection, knowing that they would not be effective. GPs who qualified before 1980 were most likely to have done this (55%). Over a quarter of GPs (28%) admitted prescribing antibiotics “several times a week,” even when not sure of their medical necessity. Over two thirds (70%) said that they did so because they did not know whether an infection was viral or bacterial, and a quarter (24%) said that this was because of a lack of easy to use diagnostic tools.
The parallel survey of patients showed that one in 10 people who visited their surgery at least once a month expected to be prescribed antibiotics every time, and another 13% expected them most of the time. Overall, around 4% of adults expected to have antibiotics prescribed every time they visited their GP and 6% on most occasions. Employment status and age had an effect on expectation levels. People who worked full time were more likely to expect antibiotic treatment every time (6%) compared with those who were not in work (1%). And although 13% of 18-24 year olds expected antibiotics most of the time, just 2% of those aged over 65 did so.
Nearly nine in 10 patients (88%) said that their main reason for requesting antibiotics was to get rid of an infection, 13% for a persistent cold or flu, 9% for an unidentifiable pain, and 9% for a child who was ill. Men were more likely than women to request antibiotics for colds or flu (16% v 9%).
Three per cent of respondents said that they stocked up on antibiotics for future use, one in 10 had used old antibiotics that they had at home, and 7% had used antibiotics that had been prescribed to family or friends. One in 20 had gone to a walk-in centre after failing to get antibiotics from a GP, and this figure was higher among 18-24 year olds (14%) and Londoners (9%).
Nearly two thirds of the patients correctly stated that antibiotics should be used against bacterial infections, but 9% thought that they should be used to treat viral infections, and 27% thought that they dealt with both types of infection. Women were more likely than men to understand that antibiotics were for bacterial infections (74% v 54%), while only 57% of people who regularly visited their surgery understood this.
Cite this as: BMJ 2014;349:g5238