Is antibiotic use overestimated?

Published in Health News and Evidence

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This article by John Dowden originally appeared in Medical Observer.*

Antibiotics are commonly prescribed by general practitioners for patients with respiratory symptoms.

To find out how many of these antibiotics are taken as directed, a consortium of 14 European research networks has carried out a prospective study in which 387 GPs recruited 3398 patients presenting with a cough.1

Antibiotics were prescribed for 1294 patients. A further 170 were given a delayed prescription.

Just over 41% of the patients given a prescription for immediate antibiotics did not take any of them. Only 44.2% took the prescribed course.

In the 28 days after their consultation, 11.6% of the patients who had not been given a prescription subsequently did obtain antibiotics, while 30.4% of those given a prescription did not use it.

Being given a prescription for an antibiotic course of more than five days was associated with reduced adherence to treatment. People who waited more than 28 days to consult their doctor were more likely to complete a course of treatment.


Counting antibiotic prescriptions does not give a true picture of antibiotic use. Consumption may be even less than this study suggests, as not all of the patients returned their 28-day diaries.

The study only included adults. Compliance may be higher in children.

Cultural factors are an important consideration in the way medicines are used. In the Bratislava network, 83% of the patients were given a prescription but only 34% took the full course.

  1. Francis NA, Gillespie D, Nuttall J, et al. Antibiotics for acute cough: an international observational study of patient adherence in primary care. Br J Gen Pract 2012; e429-37. [PubMed]

*Source: Dowden J. Is antibiotic use overestimated? Medical Observer, 9 April 2013. (Reproduced with permission.)