Reducing antibiotic pescribing

Sally Aston's picture

Reducing antibiotic prescribing…

There are lots of reasons why a particular GP may or may not give antibiotics for a cough and sometimes I feel it’s more of an art than a science. The article in Decembers BMJ ‘Investigation of lower respiratory tract infection’ (1) interested me.  It was written by a doctor returned from rural practice in Gambia where he used the WHO guidelines to diagnose lower respiratory tract infection.  These stipulate the importance of temperature, pulse and timed respiratory rate over 60 seconds.  He claims that ’any serious inflammation of the lower respiratory tract causes some degree of hypoxia, leading to tachypnoea and raised pulse rate’. 

I have given antibiotics to many patients with normal observations.  So considering the antibiotic resistance problem and that £300 million/year is wasted in England on primary and community care prescriptions of medicines (2); perhaps I should re-consider my prescribing practices. 

  1. BMJ 2011;343:d7727
  2. York Health Economics Consortium & School of Pharmacy, University of London. Evaluation of the scale, causes and costs of waste medicines. Accesssed via  (date last accessed 25.1.2012)


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