Call to reduce repeat 'within-episode' antibiotic prescriptions for respiratory tract infections in primary care

Press release issued: 8 April 2024

A new study exploring the use of repeat antibiotic prescriptions for the same respiratory tract infection (RTI) episode – known as repeat 'within-episode' prescriptions – in primary care has found high rates of their use in England, despite evidence that they are of little benefit. The study authors, from the Universities of Bristol, Bath, King's College London, and University Medical Center Utrecht, are calling for a reduction in their use and to make them a target for antimicrobial stewardship interventions.

The study, which analysed over 900,000 RTI episodes in clinical records from across 530 English general practices, found that nearly 20 per cent of adults and 10 per cent of children received a second course of antibiotics within the same episode of a lower RTI (chest infection). Almost half (48.3 per cent) of these repeat prescriptions involved the same antibiotic class.

Previous research has shown that for most child and adult patients with chest infections, particularly those without chronic lung disease, even a single antibiotic course is unlikely to have clinical benefit, raising concerns about antibiotic overuse and resistance.

Read the University of Bristol news item

Paper: 'Within-episode repeat antibiotic prescriptions in patients with respiratory tract infections: A population-based cohort study' Arief Lalmohamed et al. in the Journal of Infection [open access]