Other considerations

Medicines adherence

  • Medicines adherence may be a problem for some people taking medicines that need frequent dosing or longer treatment duration (for example, antibiotics). See the NICE guideline on medicines adherence.

Resource implications

  • Respiratory tract infections, including acute cough, are a common reason for consultations in primary care and for potential antibiotic prescribing. In a 2011 survey of UK primary care (Gulliford et al. 2014), consultations for 'cough and bronchitis' accounted for 39% of all consultations for respiratory tract infections, and the median practice issued an antibiotic prescription in 48% of these.

  • There is potential for resource savings if a no antibiotic or a back-up antibiotic prescription strategy is used. One systematic review (Spurling et al. 2017) found significantly lower antibiotic use with a back-up antibiotic prescribing strategy compared with immediate antibiotics, both when the back-up antibiotic prescription was given at the time of consultation (38.4% versus 86.8%; very low quality evidence) and when the prescription had to be collected on a separate visit (27.3% versus 95.3%; very low quality evidence).

  • Recommended antibiotics are all available as generic formulations, see Drug Tariff for costs.