Irish Medical Organisation

Antibiotics - Over used in General Practice? - Irish Medical Journal - June 2013

A study carried out amongst GPs in the Mid-Western region which is published in the Irish Medical Journal has found that there is a consensus amongst GPs that antibiotics are over used in general practice.

The specific aims of the study were to examine the attitudes and experiences of GPs in the Mid- Western region toward the use of delayed prescriptions and antibiotics in routine general practice and to describe practice demographics.

For the purpose of the survey a delayed prescription was classified as one, which is given to a patient by a doctor for an appropriate antibiotic, it is not meant to be used unless symptoms worsen or do not start to settle in the expected timescale. Authors Hayes et al note that delayed prescription have often been described as a method of compromise in situations where the doctor feels there is no clinical indication for an antibiotic, but the patient requests one. It can also provide a safety net for the doctor, as we do not know who is at risk of subsequently developing rare but important complications of infection.

The survey found:

• 63% agreed that antibiotics are over used in general practice.

• 34% felt under pressure to prescribe an antibiotic at least once a day.

• 51% agreed that delayed prescriptions have the potential to reduce antibiotic use

• 53% agreed that delayed prescriptions help to involve patients in managing their own illness

• The majority of GPs (41/39.8%) use delayed prescriptions once a week or at least once a day (34/33%).

Half of the GPs surveyed see an average of more than 30 patients per day and 43% of those surveyed see an average of 20-30 patients per day. The majority of GPs surveyed felt under pressure to prescribe antibiotics when they felt the antibiotic was unnecessary with 39% feeling under pressure to prescribe in this circumstance at least once a week and 34% at least once a day.
The authors note that overall GPs felt that delayed prescriptions had the potential to cut down on antibiotic use with 51% of GPs surveyed agreeing and 31% strongly agreeing. The majority of GPs surveyed (32%) disagreed that giving a delayed prescription increases the duration of the consultation.”

The author’s state that the findings of the survey indicate that “delayed prescription for antibiotics continues to be a useful management option for the majority of GPs surveyed.”

Previous research has shown that “As long as patients have clear and specific information about when to use antibiotics and when to return for assessment delayed prescribing of antibiotics for URTI is probably as safe as or safer than other strategies and is acceptable to patients.”

All references and author names are contained in the full article in this month’s IMJ, p. 169
Title: Delayed Prescriptions: Attitudes and Experiences of General Practitioners in the Midwest

For further information contact:
Communications Unit, Irish Medical Organisation,
10 Fitzwilliam Place, Dublin 2.
Tel. 01 676 7273

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