ArticleBMJ (Clinical research ed.)2019
Duration of antibiotic treatment for common infections in English primary care: cross sectional analysis and comparison with guidelines.
Article in BMJ (Clinical research ed.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 4 of them syntheses that pooled it.
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Who cites it
63 citing papers in PubMed, 4 syntheses or guidelines pooled it, 125 citations in OpenAlex.
- Factors contributing to the variation in antibiotic prescribing among primary health care physicians: a systematic review.BMC primary care · 2024Pooled it
- Physicians', pharmacists', and nurses' education of patients about antibiotic use and antimicrobial resistance in primary care settings: a qualitative systematic literature review.Frontiers in antibiotics · 2024Pooled it
- Pooled it
- Clinical practice guidelines for acute otitis media in children: a systematic review and appraisal of European national guidelines.BMJ open · 2020Pooled it
- Antibiotic Use and Subsequent Cognitive Decline and Dementia Risk in Healthy Older Adults.Neurology · 2025Trial
- A pragmatic randomized trial of a primary care antimicrobial stewardship intervention in Ontario, Canada.BMC family practice · 2021Trial
- Trial
- Ethics of Antibiotic Course Duration: Shorter is Better.The American journal of bioethics : AJOB · 2026Article
- Article
- Exploring factors contributing to antibiotic resistance: A cross-sectional empirical study in Bangladesh.PloS one · 2026Article
- Bacterial profile and antibiotic resistance pattern of uropathogens isolated from patients with complicated urinary tract infections in a tertiary care hospital in Dhaka, Bangladesh.BMC infectious diseases · 2025Article
- Tailoring Antibiotic Duration for Respiratory Tract Infections in Primary Care: Protocol for a Pragmatic Randomized Controlled Trial Study (STORM).JMIR research protocols · 2025Article
- Knowledge and behaviors of Turkish dentists regarding rational drug use in pediatric patients: a cross-sectional survey.BMC oral health · 2025Article
- Antibiotic prescribing intensity and community UTI resistance: a cross-sectional ecological study.BJGP open · 2025Article
- Reducing antibiotic prescribing rates in young children in an outpatient primary care setting-a systemwide quality improvement initiative.JAC-antimicrobial resistance · 2025Article
- Duration of antibiotic treatment for respiratory tract infections in primary care.JAC-antimicrobial resistance · 2025Article
- Dynamic analysis of the epidemiology and pathogen distribution of bronchoalveolar lavage fluid in children with severe pulmonary infection: a retrospective study.Italian journal of pediatrics · 2025Article
- Evaluation of antibiotic prescribing for the treatment of male community-acquired urinary tract infections using reimbursement data.PloS one · 2025Article
- Long-Term Outcomes of a Health Information System-Based Feedback Intervention Study of Antimicrobial Prescriptions in Primary Care Institutions: Follow-Up of a Randomized Cross-Over Controlled Trial.Infection and drug resistance · 2025Article
- Stop antibiotics when you feel better? Opportunities, challenges and research directions.JAC-antimicrobial resistance · 2024Review
3 more citing papers are in PubMed but not listed here.
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Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the duration of prescriptions for antibiotic treatment for common infections in English primary care and to compare this with guideline recommendations.
designCross sectional study.
settingGeneral practices contributing to The Health Improvement Network database, 2013-15.
participants931 015 consultations that resulted in an antibiotic prescription for one of several indications: acute sinusitis, acute sore throat, acute cough and bronchitis, pneumonia, acute exacerbation of chronic obstructive pulmonary disease (COPD), acute otitis media, acute cystitis, acute prostatitis, pyelonephritis, cellulitis, impetigo, scarlet fever, and gastroenteritis.
main outcome measuresThe main outcomes were the percentage of antibiotic prescriptions with a duration exceeding the guideline recommendation and the total number of days beyond the recommended duration for each indication.
resultsThe most common reasons for antibiotics being prescribed were acute cough and bronchitis (386 972, 41.6% of the included consultations), acute sore throat (239 231, 25.7%), acute otitis media (83 054, 8.9%), and acute sinusitis (76 683, 8.2%). Antibiotic treatments for upper respiratory tract indications and acute cough and bronchitis accounted for more than two thirds of the total prescriptions considered, and 80% or more of these treatment courses exceeded guideline recommendations. Notable exceptions were acute sinusitis, where only 9.6% (95% confidence interval 9.4% to 9.9%) of prescriptions exceeded seven days and acute sore throat where only 2.1% (2.0% to 2.1%) exceeded 10 days (recent guidance recommends five days). More than half of the antibiotic prescriptions were for longer than guidelines recommend for acute cystitis among females (54.6%, 54.1% to 55.0%). The percentage of antibiotic prescriptions exceeding the recommended duration was lower for most non-respiratory infections. For the 931 015 included consultations resulting in antibiotic prescriptions, about 1.3 million days were beyond the durations recommended by guidelines.
conclusionFor most common infections treated in primary care, a substantial proportion of antibiotic prescriptions have durations exceeding those recommended in guidelines. Substantial reductions in antibiotic exposure can be accomplished by aligning antibiotic prescription durations with guidelines.
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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.