Medical researchers at Southampton have made a significant contribution towards reducing the global threat of antibiotic resistance. Their studies have provided an evidence base for more effective antibiotic prescribing practices in UK and around the world.
One of the major drivers for rising levels of resistant bacteria is the unnecessary prescription of antibiotics by GPs. In the mid-1990s, a research group at Southampton, which included Professor Paul Little, Dr Ian Williamson, Dr Michael Moore and Dr Hazel Everitt, embarked on a series of trials to assess the effectiveness of different antibiotic prescribing strategies. The first trial involved 700 patients which sore throats, one of the most common respiratory illnesses for which people consult their GPs., funded by the Department of Health.
The participants received one of three antibiotic prescribing strategies: immediate prescription, no prescription , and, if symptoms did not settle after three days, delaying prescription. The research was desgined, not only to assess the effectiveness of the different strategies, but also the ‘medicalisation’ of illness – that is, the effect of prescriptions on patients’ belief in the power of antibiotics and their intention to consult their GP again for similar treatment.
The research found that prescribing antibiotics for sore throats did not reduce the extent and duration of the symptoms. However, the strategies of offering no antibiotics or delaying prescribing significantly reduced patient’s belief in the power of antibiotics and their intention to ask their GP for antibiotics in future.
Further trials looking at antibiotic prescription for other infections, such as sinusitis, ear infections, conjunctivitis and lower respiratory tract infections resulting in similar findings and common key recommendations for GPs – to avoid or delay prescribing antibiotics as part of a national strategy to reduce the risk of antibiotic resistance.
The work has influenced a number of important national clinical guidelines and the implementation of new prescribing strategies. As a direct result of the research, delayed prescribing for all acute respiratory infections is a tool in the very day practice of GPs in the UK. Southampton’s work in the field has also informed guidelines around the world, including in the United States, Israel and throughout the European Union.
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