Home Forums General Medicine Stop giving antibiotics for sore throats

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    In Britain GPs are handing out more than a million antibiotic prescriptions for sore throats every year, increasing the threat of drug-resistant bacteria. National Institute for Health and Care Excellence (NICE) has directed doctors to tell patients to take paracetamol rather than prescribe antibiotics. It says that GPs prescribe antibiotics in 60 per cent of cases despite the fact that studies suggest between 70 and 95 per cent of throat infections are caused by viral infections, meaning that the drugs will be ineffective. About 3.4 million GP appointments are made for sore throats each year.

    Most people’s symptoms will clear up regardless of the cause within a week with no treatment at all, the guidelines produced together with Public Health England (PHE) say, and “withholding antibiotics rarely leads to complications” even if they would have shortened the illness. Cliodna McNulty, head of the primary care unit at PHE, said: “Antibiotics are a precious resource and it’s important that they are only used when they are really needed.”

    Overuse of antibiotics can lead to the development of strains of resistant bacteria, which are forecast to cost up to ten million lives per year globally by 2050. England’s chief medical officer, Dame Sally Davies, has warned that we face a “post-antibiotic apocalypse” in which diseases including cancer will become untreatable if the issue is not brought under control.

    The NHS suggests you can soothe it and shorten how long it lasts by drinking plenty of water, avoiding hot drinks, and resting. It also says sufferers should eat cool, soft food, avoid smoking or smoky places and try sucking ice cubes and ice lollies. Adults can try gargling with warm, salty water, although children should not try it.

    You can take paracetamol or ibuprofen to relieve the pain and discomfort and some people choose to use medicated lozenges or anaesthetic sprays, although there is little firm evidence that they help.

    The advice is to see a GP only if your sore throat does not improve after a week or if you have a very high temperature or feel hot and shivery; or you have a weakened immune system. If it is accompanied by breathing difficulties the advice is to call 999.

    Official figures showed a 13 per cent reduction in antibiotic prescriptions by GPs between 2012 and 2016. However, Nice pointed out that a 2014 study based on 568 general practices showed that 60 per cent of patients with sore throats received antibiotics.

    Surveys of doctors frequently find that GPs feel pressure from patients to prescribe antibiotics, or prefer handing them out to offering no treatment at all. They may also err on the side of caution if they are unsure whether an infection is viral or bacterial. Helen Stokes-Lampard, chairwoman of the Royal College of GPs, said: “We must use [antibiotics] sparingly and only when they are appropriate. We need our patients’ help with this by understanding that antibiotics are not a cure for every ill.”

    In India antibiotics are available over the counter at most chemists. Patients usually go directly to the chemist and request an antibiotic. I am not sure if regulations indicate that it must be dispensed only with a doctor’s prescription.

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