Antibiotic prescribing is fuelling superbugs as some GPs prescribe twice as many as others

Having met with professionals this week who tell us there are now infections that are untreatable we can only say just how dismayed we are to hear that family doctors in some areas are handing out twice as many antibiotics than others.

The figures raise questions about over-use of antibiotics after doctors admitted issuing antibiotics to appease parents and get rid of patients faster according to the Daily Telegraph.

The study showed that prescribing rates actually increased after a government advertising campaign aimed at cutting use of antibiotics for coughs and colds as they do not work against viruses.

NHS data shows that there is a 125 per cent difference in antibiotic prescribing between the top and bottom clinical commissioning group area.

In Camden, north London, there were 40,102 prescriptions written for antibiotics for every 100,000 people in 2013/14 compared with 89,763 in South Tees. The ten clinical commission group areas with the lowest prescribing rates are all in London, which has high rates of pollution and deprivation and has the highest rate of tuberculosis which requires long courses of antibiotics to treat. The ten areas with the highest prescribing rates are largely but not exclusively in the north where smoking rates tend to be higher.

Nationally 69,586 prescriptions per 100,000 were issued in 2013/14 at a cost of almost £184m.

Tackling prescribing rates by individual GP practice is needed urgently, the emergence of untreatable infections for patients undergoing surgery is the price we are now paying, and this is likely to become more widespread. And the more powerful antibiotics are now being used for infections in hospitals as clinicians are using what should be drugs of last resort as a their first line of defence, storing up problems for these patients in the future.

No matter what patients may “demand” GPs must adhere to good prescribing practice. The days of giving a patient a prescription for antibiotics “just in case” has to end.

Dame Sally Davies, Chief Medical Officer said: "Medical staff are on the front line in our fight against drug resistance but everybody must act now to stop it in its tracks. Clinicians, patients and the public can all help to make sure existing antibiotics remain effective through better infection prevention, better diagnosis and more appropriate prescribing.

"Strong action is being taken to cut prescription rates. A number of Royal Colleges recently joined forces and asked their members to get behind our antimicrobial resistance strategy. More effective prescribing is a key part of this. Researchers will also be looking to use develop technologies to help doctors diagnose easier and prescribe better in the future to enable more effective diagnosis and treatment."

The research, funded by the Health Protection Agency (HPA) and published in the Journal of Antimicrobial Chemotherapy. concludes that, "The implementation of national guidelines in UK primary care has had mixed success, with prescribing for coughs/colds, both in total and as a proportion of consultations, now being greater than before recommendations were made to reduce it. Extensive variation by practice suggests that there is significant scope to improve prescribing, particularly for coughs/colds and for UTIs."


The ten lowest CCG prescribing areas, items per 100,000 population
• Camden 40,102
• City & Hackney 43,988
• West London (K&C and QPP) 44,447
• Haringey 46,603
• Tower Hamlets 47,425
• Westminster 47,875
• Islington 48,786
• Nottingham West 48,789
• Southwark 49,361
• Lambeth 49,600
The ten highest CCG prescribing areas
• South Tees 89,763
• Blackpool 89,307
• Knowsley 88,919
• St Helens 87,992
• Southend 87,580
• Durham Dales, Easington and Sedgefield 85,543
• Heywood, Middleton and Rochdale 85,464
• Birmingham South and Central 85,113
• Bradford City 83,633
• Lincolnshire East 82,747

Derek Butler
MRSA Action UK
Tel No 07762741114