Antibiotics

Biography

Biography: Martin Duerden

Abstract

In the UK 60% of all antibiotic prescriptions are for upper respiratory tract infections (URTIs), although for 60 - 90% of these an antibiotic will not provide resolution or symptom relief. Inappropriate prescribing contributes to antibiotic resistance (AMR), a WHO-recognised urgent issue threatening global health.We conducted an online multinational study of URTI patients in 33 countries (~500 in each). In the UK 68% of healthcare practitioner encounters for URTI in the last year were with a GP; of these 24% resulted in antibiotic prescription. Comparable rates of GP prescribing were seen in several other countries; e.g. USA (24%), Mexico (23%), and South Africa (26%), underscoring the global dimension of inappropriate prescribing. In the UK concerns around AMR have been raised by the Prime Minister and the Chief Medical Officer with forthcoming reports on antibiotic stewardship and risk-related behaviours from The National Institute for Health and Care Excellence (NICE). The Global Respiratory Infection Partnership (GRIP), a group of international experts, was established in 2011 to promote rational antibiotic use and stewardship for URTIs. Practical steps at national and local levels are urgently needed to bring about change, especially in behaviours. GRIP have created useful resources for multiple stakeholders to identify high risk patients and promote symptomatic relief for others.Despite considerable efforts, these UK data show continuing inappropriate antibiotic prescribing for URTIs, especially in primary care. Further education of GPs and patients is required. This is recognised as paramount and, based on its ‘5P’ framework, GRIP is committed to promoting non-antibiotic, symptomatic relief for self-limiting conditions.