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    The content on this page is not current guidance and is only for the purposes of the consultation process.

    Consultation on new and updated NICE indicators: GID-IND10330 to GID-IND10335 & GID-IND10337 to GID-IND10338

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    Infections: delayed antibiotic prescribing

    GID-IND10323: The percentage of recorded sore throat, otitis media, sinusitis or cough in the preceding 12 months resulting in the provision of self-care advice only or back up delayed prescription for antibiotics.

    Indicator type

    General practice indicator suitable for use in the QOF

    Rationale

    Providing 'self-care advice only' or 'back-up (delayed)' prescriptions can help to prevent overuse of antibiotics, reduce antibiotic resistance and result in fewer side effects for patients from antibiotics. Sore throat, otitis media, sinusitis or cough are all conditions in which most people would not benefit from provision of an antibiotic.

    Source guidance

    NICE's guideline on sore throat (2018) recommendations 1.1.1 and 1.1.12.

    NICE's guideline on otitis media (2018) recommendations 1.1.1 and 1.1.13.

    NICE's guideline on sinusitis (2017) recommendations 1.1.1 and 1.1.8.

    NICE's guideline on cough (2019) recommendations 1.1.8 and 1.1.14.

    Specification

    Numerator: The number in the denominator resulting in the provision of self-care advice only or back up delayed prescription for antibiotics.

    Denominator: The number of recorded sore throat, otitis media, sinusitis or cough in the preceding 12 months.

    Definitions:

    Provision of 'self-care advice only' will be inferred from the use of appropriate self-care advice codes and no antibiotic prescription within 3 days.

    Back-up (delayed) prescriptions are a prescribing strategy where a healthcare provider issues a prescription for antibiotics but advises the patient to wait before filling it and to only fill it if certain conditions worsen or persist after a set period, usually 48 to 72 hours.

    Exclusions:

    • People who are immunosuppressed (all ages)

    Question for consultation:

    8. Are there concerns about unintended consequences, such as increased follow-up visits or complications?

    9. What practical challenges might clinicians face in integrating this indicator into routine practice?