Delayed prescriptions could help fight antibiotic resistance

Delayed prescriptions or shorter courses of treatment could be a potential way of fighting antibiotic resistance, suggest two studies led by University of Southampton in Britain.

"Antibiotic resistance is now considered a global health crisis and one of the contributors is over-prescription of the drugs. We need to adopt new approaches if we are going to reduce our over-reliance on antibiotics," said Professor Michael Moore, who led both studies published in the British Journal of General Practice.

The first study concluded that doctors could use antibiotic prescriptions for sore throats but tell patients not to take them straight away.
Issuing an antibiotic prescription with the instruction of not to 'cash it in' unless symptoms persisted was as effective as giving them the drugs immediately, the study said.

The second study showed that shorter courses of antibiotics for sore throats (a five-day course, instead of the ten-day course) could be just as effective and help reduce over-consumption of antibiotics.

"A 'wait and see' approach seems to have similar benefits to a prescription on symptoms approach; and we found that less people end up using them. A shorter course of antibiotics does not seem to have disadvantages and is another way of reducing exposure to antibiotics," Moore said.
Both studies were observational studies. The researchers followed thousands of patients who presented with a sore throat.

In the first study, patients who were given antibiotics straight away started to recover around a day sooner than those given no prescription at all. Patients given a delayed prescription experienced a similar recovery rate to those given immediate antibiotics.

The research team believe this was because most infections clear up on their own with no need for antibiotics, while patients felt reassured by the knowledge they had a prescription they could use just in case.

In the second study the researchers looked at those treated with an antibiotic and compared recovery rates for those given five, seven or ten days treatment.

Those on the ten-day course were slightly less likely than those on the five-day course to revisit their GP with new or persisting symptoms. But the difference was very small and was not statistically significant.

"Adopting shorter courses could be an effective strategy to reduce exposure to antibiotics. However, it is important to test this theory further in controlled trials before GPs (general practitioners) guidelines are amended to recommend shorter courses," Moore said.