Alternative prescribing strategies for respiratory tract infections
Each year one in four people visits their GP because of an acute respiratory tract infection (RTI). Treatment for RTIs accounts for 60% of all antibiotic prescribing in general practice. Yet the clinical evidence is that antibiotics have limited effectiveness in many of these cases and that complications are rare among people who are not prescribed antibiotics to treat the infection.
In July 2008, NICE published a short clinical guideline recommending alternative prescription strategies for people presenting with RTI in primary care and other first-contact centres such as emergency departments and walk-in centres.
Good practice starts with a clinical assessment to diagnose and exclude complications. Some patients, such as children aged under 2 years with acute infections in both ears and older people who have other pre-existing health conditions, should receive an immediate antibiotic prescription.
But where the evidence shows that antibiotics will make little difference, patients should not be prescribed them or they should be given a prescription to keep and use only if the symptoms worsen. GPs should always explain the options and reasons behind their decision.
Anne Joshua, Associate Director of Pharmacy at NHS Direct and guideline development group member, said: "This short clinical guideline brings together everything we know on targeting antibiotics to those who really need them. It sets out very clearly the information that should be provided by healthcare professionals when they are assessing children and adults presenting with RTI symptoms in order to reassure them that they are receiving the most effective course of treatment, based on the most up-to-date evidence."
This page was last updated: 10 August 2009