Study recommends scaling down antibiotic prescriptions to curb antibiotic resistance 

Factors such as the doctor not knowing the patient, limited access to scans or testing or a high workload can increase the chances of antibiotic prescribing, the study said. 

Antibiotics can save lives but their use can also drive antibiotic resistance, which is “a major threat to public health”, researchers in Cork have found.

A study on two years of antibiotic prescribing at Southdoc found 59% were for respiratory illnesses. The study advised a focus on reducing this trend, particularly for children, to help prevent antibiotic resistance.

Overall, children under six accounted for 21% of all antibiotics prescribed during 2020 and 2021, the study carried out by GPs and University College Cork found. They found 95% of antibiotics for sexually transmitted infections were for men, and 82% of antibiotics for urinary tract infections were for women.

They pointed to previous research showing Irish primary care services have a reliance “higher than the European mean” on antibiotics according to the European Centre for Disease Prevention and Control.

This new study looked at antibiotic prescribing in Cork and Kerry Southdoc out-of-hours GP services from 2019 to 2021. While there is no centralised data collection of antibiotic prescriptions in Ireland for out of hours, GPs in these counties have been working with a system which records data since December 2019.

Over the two years, 21% of antibiotics were for children under six while the median age was 29. The study identified 65 antibiotic prescriptions per 1,000 children aged under six years during 2020. But in 2021, as normal socialising resumed after covid-19 lockdowns, they found this rose to 113 per 1,000.

This study did not ask parents what they think about antibiotics. However, they shared previous research showing parents are happier if an antibiotic is prescribed and complain if they do not get one.

They also said other research shows a thorough examination and reassurance is acceptable to some parents, with a non-antibiotic management plan.

The researchers, including Southdoc medical director Dr Gary Stack, said that since the introduction of free GP care for under sixes more children have attended which affects the number of antibiotics prescribed.

Antibiotics in all cases were most commonly prescribed for respiratory illness, at 59% of the total. These figures indicate a chance to improve how antibiotics are used by “addressing the volume of antibiotic prescribing for RTIs, particularly in children", the researchers said.

This is likely to be complex, they found, as previous research showing out-of-hour consultations are more likely to be urgent.

Other factors such as the doctor not knowing the patient, limited access to scans or testing or a high workload can increase the chances of antibiotic prescribing, they said. 

Some 17% of 406,812 consultations resulted in an antibiotics prescription. During the pandemic months, 66% of 49,421 antibiotic prescriptions followed remote appointments.

Breaking down the figures by gender, the study indicates 60% of all antibiotics were for females. 

“Males accounted for a higher proportion of antibiotics for STIs (95%), and females for UTIs (82%),” they found. The authors advised this indicates a need for targeted education on preventative measures for these groups.

The study Trends in antibiotic prescribing in primary care out-of-hours doctors’ services in Ireland was published in the journal JAC Antimicrob Resist.