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Standardise antibiotic use

24 June 2009


Prescribing antibiotics for acute coughs should be standardised across Europe to help cut the number of inappropriate prescriptions and tackle the growing problem of antibiotic resistance, a major new University-led research study has concluded.

In the largest study of its kind a team of researchers led by Professor Christopher Butler, School of Medicine, mapped variations in antibiotic prescribing for acute coughs across Europe, and its impact on recovery.

Inappropriate prescribing of antibiotics and antibiotic resistance remains a growing problem. In Europe, 10% of Streptococcus pneumoniae bacteria are recorded as non-susceptible to penicillin and unnecessary antibiotic prescribing, particularly for respiratory illnesses, has been blamed for increasing antibiotic resistance.

The study, published in the BMJ, found wide variation between countries in the chances of being prescribed an antibiotic. In some countries, the study found that the odds of being prescribed an antibiotic was over five times greater than the overall average, and in another over five times less.

Professor Butler is now calling for antibiotic prescribing for respiratory illnesses to be standardised across Europe.

Professor Butler said, "The research provides evidence that antibiotics are still considerably over-prescribed for acute cough and that the big differences in antibiotic prescribing between countries are not justified on clinical grounds. It therefore identifies a major opportunity for greater standardisation of care for this exemplar common acute condition across Europe.

"Implementation of improved standardisation of care should result in considerable progress in reducing unnecessary antibiotic use and will be a key weapon in containing antibiotic resistance, one of the most urgent threats to the public health in the modern age."

Despite the variation in antibiotic prescribing between countries, patients recovered at a similar rate, regardless of whether or not they were prescribed an antibiotic for acute cough. So the variation in antibiotic prescribing was found not to benefit the patient.

The study is part of a major European-wide project called GRACE. GRACE brings together 28 academic groups with a wide spectrum of expertise, spread across 13 EU Member States with the aim of combat antimicrobial resistance.

The EU funded study also seeks to explain the underlying reasons for the variation in management through one of the largest-ever qualitative explorations of infections.

Professor Herman Goossens of the University of Antwerp who coordinates the GRACE Network of Excellence added, "This threat of antibiotic resistance is likely to be more acute as GPs face increasing demands to prescribe antibiotics for acute cough amidst the current global H1N1 flu pandemic. This new evidence should prove instrumental in containing antibiotic prescribing."

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