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Research looks at ways to reduce the over-prescribing of antibiotics

Published on May 22, 2009 at 4:59 AM · No Comments

Improving communications skills and the use of a simple blood test could help cut the growing number of inappropriate prescriptions of antibiotics, a joint Cardiff University trial has discovered.

In a major new clinical trial, published in the British Medical Journal, a team of researchers from Cardiff University's School of Medicine together with researchers from the Maastricht University Medical Centre in the Netherlands found those GPs in primary care who underwent training in advanced communications skills and those who made use of a simple blood test prescribed fewer antibiotics for lower respiratory tract infections, which generally do not respond to antibiotics.

Professor Christopher Butler, Head of Department of Primary Care and Public Health at Cardiff University who led the trial, said: "As the problem of bacteria resistant to antibiotic treatment grows, researchers from around the world are seeking ways to improve the quality of antibiotic prescribing. Prescribing antibiotics only when patients will clearly benefit, reduces the pressure that drives antibiotic resistance.

"Conditions like acute bronchitis account for some 80% of all lower respiratory tract infections and despite evidence of little or no benefit from antibiotics, the majority of these patients are still prescribed antibiotics.

"We know that with the many pressures facing GPs, including worry about leaving pneumonia untreated, they often give patients "the benefit of the doubt" and prescribe antibiotics. Our clinical trial therefore sought to evaluate ways antibiotic prescribing could be reduced without adversely affecting patient recovery or satisfaction with care."

The trial evaluated an 'illness focussed' approach, where clinicians seek to better understand the patient's illness experience and communicate more effectively about management, and a 'disease focussed' approach, where clinicians focus on diagnosis, in this case, a simple point-of-care blood test.

The trial randomised 20 general practices in the Netherlands, where 40 GPs managed 431 patients with lower respiratory tract infection.

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