BMJ  2005;331:301-302 (6 August), doi:10.1136/bmj.331.7512.301

Editorial

Delayed prescribing of antibiotics for upper respiratory tract infection

With clear guidance to patients and parents it seems to be safe

The first 150 words of the full text of this article appear below.

The use of antibiotics by children with upper respiratory tract infection halved in the last decade in the United Kingdom, according to a paper in this week's BMJ (p 328).¹ Sharland and colleagues attribute this decline to an initially sharp reduction in prescribing by general practitioners and, since 1997, to a reduction in the proportion of prescriptions taken by parents to a pharmacist. Widespread adoption of delayed prescribing, a strategy tested in a randomised controlled trial published in 1997, may well explain this pattern.^{1 2}

Whether patients fill prescriptions depends, however, on the method of delayed prescribing. Retrospective data and historical comparisons—albeit limited scientifically—suggest that giving a prescription and asking the patient or parent to redeem it only if symptoms persist is more likely to result in antibiotic use than is asking the patient to return to the doctor for a prescription. This is the policy we used . . . [Full text of this article]

Primary Medical Care, Community Clinical Sciences Division, Southampton University, Aldermoor Health Centre, Southampton SO16 5ST
(psl3@soton.ac.uk)

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This article has been cited by other articles:

• Thompson, P L, Spyridis, N, Sharland, M, Gilbert, R E, Saxena, S, Long, P F, Johnson, A P, Wong, I C K (2009). Changes in clinical indications for community antibiotic prescribing for children in the UK from 1996 to 2006: will the new NICE prescribing guidance on upper respiratory tract infections just be ignored?. Arch. Dis. Child. 94: 337-340 [Abstract] [Full text]  
• Butler, C. C, Francis, N. (2008). Commentary: Controversies in NICE guidance on antibiotic prescribing for self limiting respiratory tract infections in primary care. BMJ 337: a656-a656 [Full text]  
• Petersen, I., Hayward, A. C., on behalf of the SACAR Surveillance Subgroup, (2007). Antibacterial prescribing in primary care. J Antimicrob Chemother 60: i43-i47 [Abstract] [Full text]  
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