GPs prescribing antibiotics often rely on their personal preferences and experience, rather than clinical evidence, says new research launched at the British Pharmaceutical Conference (BPC) in Manchester.

The risk associated with this behaviour is that the drug prescribed may be unnecessary or inappropriate, increasing the potential for antibiotic resistance and adding costs to the Primary Care Trust (PCT), pharmacists at Liverpool’s John Moore’s University concluded.

Researchers investigated whether GPs were adhering to local PCT guidelines for infection control when prescribing certain specialist and expensive antibiotics (co-amoxiclav and clarithromycin). They also compared results to those of a similar 2005 study.

Guidelines say these drugs should only be used as the first-line treatment for very few conditions, but the research found these drugs accounted for 15% of all antibacterials prescribed in the study, and often for conditions not included in the PCT guidelines.

80% of antibiotics prescribed in the UK are in primary care. Doctors find antibiotic therapy difficult because of perceived pressure from patients to prescribe antibiotics that GPs don’t believe are clinically justified, set against their worry about failure to treat the small number of cases which lead to serious complications.1

Following the 2005 research, some education and information support on antibacterial prescribing was provided to GPs. The PCT is also introducing a computer software package that highlights to GPs drug therapy alternatives and potentially better drug therapy choices.

Rachel Aspinall who led the research, said: “There are serious risks associated with prescribing based on preference and experience - it can lead to the chosen drug being inappropriate or completely unnecessary.

“Inappropriate prescribing can also reduce the effectiveness of antibiotics for patients who may need them in the future, and potentially lead to complete antibiotic resistance. So, it’s important GPs are given more support in prescribing. Pharmacists are experts in medicines, and therefore ideally placed to provide support of this kind to ensure all patients receive the best possible healthcare.”

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