Intended for healthcare professionals


Controlling antibiotic prescribing for lower respiratory tract infections

BMJ 2017; 357 doi: (Published 22 May 2017) Cite this as: BMJ 2017;357:j2398
  1. Anna Mae Scott, senior research fellow,
  2. Chris Del Mar, professor of public health
  1. Centre for Research in Evidence Based Practice, Bond University, Gold Coast, Queensland 4229, Australia
  1. Correspondence to: C Del Mar cdelmar{at}

Prescribing less is safe for patients and better for all of us

We are prescribing antibiotics too often, especially for acute respiratory infections for which we know they make little difference. General practitioners everywhere have heard this message many times, but they struggle to take the necessary remedial action. One influential report from the UK sketches a worrying picture of a “post-antibiotic” world of widespread antibiotic resistance in which more people will die of incurable infections than of cancer. The report predicts that by 2050 incurable infections will be the second biggest killer,1 while currently routine high technology medical interventions (cardiac catheterisation, chemotherapy and radiotherapy for cancer, and major surgery) will become too dangerous without reliable antibiotic cover. The human and economic consequences would be catastrophic.1

Antibiotic prescribing in primary care is in the spotlight for two reasons: it is where the greatest raw tonnage of antibiotics is prescribed to humans (about three quarters of all prescriptions are …

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