Evidence map›Paper›PMID 25348424›Full record

ArticleBMJ open2014

Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices.

Martin C Gulliford, Alex Dregan, Michael V Moore, Mark Ashworth, Tjeerd van Staa, Gerard McCann, Judith Charlton, Lucy Yardley, Paul Little, Lisa McDermott

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 148 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
148citing papers in PubMed, 13 pooled it
14.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

148 citing papers in PubMed, 13 syntheses or guidelines pooled it, 282 citations in OpenAlex.

  1. Pooled it
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  5. Group C beta hemolyticScandinavian journal of primary health care · 2020
    Pooled it
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  7. Corticosteroids as standalone or add-on treatment for sore throat.The Cochrane database of systematic reviews · 2020
    Pooled it
  8. Guideline
  9. Comparison of Centor and McIsaac scores in primary care: a meta-analysis over multiple thresholds.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020
    Pooled it
  10. Pooled it
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  12. Antibiotics for acute rhinosinusitis in adults.The Cochrane database of systematic reviews · 2018
    Pooled it
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  14. Nasal sprays and a behavioural intervention for respiratory tract infections in primary care: 12-month follow-up of a randomised open-label trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
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  19. Probiotic capsules and xylitol chewing gum to manage symptoms of pharyngitis: a randomized controlled factorial trial.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2017
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88 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Martin C GullifordKing's College London, Primary Care and Public Health Sciences, London, UK.
Alex DreganKing's College London, Primary Care and Public Health Sciences, London, UK.
Michael V MooreDepartment of Primary Care and Population Sciences, University of Southampton, Southampton, UK.
Mark AshworthKing's College London, Primary Care and Public Health Sciences, London, UK.
Tjeerd van StaaClinical Practice Research Datalink (CPRD) Division, Medicines and Healthcare Products Regulatory Agency, London, UK.
Gerard McCannClinical Practice Research Datalink (CPRD) Division, Medicines and Healthcare Products Regulatory Agency, London, UK.
Judith CharltonKing's College London, Primary Care and Public Health Sciences, London, UK.
Lucy YardleyDepartment of Primary Care and Population Sciences, University of Southampton, Southampton, UK.
Paul LittleDepartment of Primary Care and Population Sciences, University of Southampton, Southampton, UK.
Lisa McDermottKing's College London, Primary Care and Public Health Sciences, London, UK.
King's College London · GBUniversity of Southampton · GBClinical Practice Research Datalink · GB

Funding

Medical Research Council MC_PC_13042Medical Research Council MR/K006665/1Wellcome TrustWellcome Trust WT086129MA
6 · The paper itself

Abstract

objectivesOverutilisation of antibiotics may contribute to the emergence of antimicrobial drug resistance, a growing international concern. This study aimed to analyse the performance of UK general practices with respect to antibiotic prescribing for respiratory tract infections (RTIs) among young and middle-aged adults.

settingData are reported for 568 UK general practices contributing to the Clinical Practice Research Datalink.

participantsParticipants were adults aged 18-59 years. Consultations were identified for acute upper RTIs including colds, cough, otitis-media, rhino-sinusitis and sore throat. PRIMARY AND SECONDARY OUTCOME MEASURES: For each consultation, we identified whether an antibiotic was prescribed. The proportion of RTI consultations with antibiotics prescribed was estimated.

resultsThere were 568 general practices analysed. The median general practice prescribed antibiotics at 54% of RTI consultations. At the highest prescribing 10% of practices, antibiotics were prescribed at 69% of RTI consultations. At the lowest prescribing 10% of practices, antibiotics were prescribed at 39% RTI consultations. The median practice prescribed antibiotics at 38% of consultations for 'colds and upper RTIs', 48% for 'cough and bronchitis', 60% for 'sore throat', 60% for 'otitis-media' and 91% for 'rhino-sinusitis'. The highest prescribing 10% of practices issued antibiotic prescriptions at 72% of consultations for 'colds', 67% for 'cough', 78% for 'sore throat', 90% for 'otitis-media' and 100% for 'rhino-sinusitis'.

conclusionsMost UK general practices prescribe antibiotics to young and middle-aged adults with respiratory infections at rates that are considerably in excess of what is clinically justified. This will fuel antibiotic resistance.

Indexed as

General PracticeAdolescentAdultAnti-Bacterial AgentsCommon ColdCoughDatabases, FactualFemaleHumansInappropriate PrescribingMaleMiddle AgedOtitis MediaPharyngitisPractice Patterns, Physicians'Respiratory Tract InfectionsAnti-Bacterial AgentsPUBLIC HEALTH

Identifiers

PMID25348424
PMCPMC4212213
OpenAlexW2171661586

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.