A recent study published in the British Medical Journal once again highlights the serious issue of antibiotic resistance that we are facing, this time in the primary care setting.
In the study, researchers from Cardiff University studied prescriptions from UK primary care for four infections over a period of 22 years, that is, between 1991 and 2012, to analyze for antibiotic resistance. The infections were upper and lower respiratory infections, skin and soft tissue infections and acute otitis media, for which antibiotics are frequently prescribed.
AdvertisementMost of the antibiotics prescribed in the study were for lower respiratory tract infections. The most commonly prescribed antibiotics during this period were amoxicillin, penicillin-V and flucloxacillin.
Antibiotic treatment failure was considered present if any of the following was observed within 30 days of the use of the first antibiotic - prescription of a different drug, hospitalization or death due to an infection, or referral to an infection specialist service. In addition, patients who visited an emergency department within three days of starting the antibiotic were also included as treatment failures.
The researchers found that there was an increase in the rate of antibiotic treatment failure over this period of 22 years of 12%. When considered individually, lower respiratory tract infections showed an increase in failure of 35%. Among the antibiotics, trimethoprim showed an increase in failure rate of 40% when used for upper respiratory tract infections. The increase in treatment failure rates was less for the first-line antibiotics like antibiotics and macrolides. The antibiotic failure rate was highest in the last twelve years of the study, when the use of antibiotics increased.
Thus, antibiotic resistance is not only a concern for hospitals; primary health doctors should also be aware of the current situation and take adequate precautions to prevent this problem from growing.
Steps you can take to prevent antibiotic resistance:
• Take an antibiotic only that is prescribed by a doctor for the particular illness.
• Take the full course of the antibiotic; do not stop it even if you feel better.
• In some cases, for example, in tuberculosis, your doctor will prescribe more than one antibiotics for you to take simultaneously. Make sure you take all of them.
1. Curie CJ et al. Antibiotic treatment failure in four common infections in UK primary care 1991-2012: longitudinal analysis. BMJ 2014;349:g5493 doi: 10.1136/bmj.g5493
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