NICE tells doctors to avoid antibiotics for RTIs

The National Institute for Health and Clinical Excellence has published guideline on the use of antibiotics for respiratory tract infections recommending that alternative prescription strategies are used for patients with RTIs who present in primary care and other first face-to-face contact health care settings such as emergency departments and walk-in centers in England, Wales and Northern Ireland.

The government agent that advises the UK's National Health Service on the use of drugs and other treatments suggests that no antibiotics should be prescribed at first, with one written for use at a later date should symptoms worsen, as well as immediate antibiotic prescribing. Evidence shows that antibiotics have limited effectiveness in treating a large proportion of RTIs and complications are likely to be rare if antibiotics are withheld, the NICE said. Consultation rates in England and Wales show that a quarter of the population will visit their general practicioner because of an RTI each year and they are the reason for 60% of all antibiotic prescribing in this setting.

Key recommendations to doctors in the guidelines are: "negotiate a no antibiotic or delayed antibiotic prescribing strategy for patients with acute otitis media, acute sore throat/pharyngitis/acute tonsillitis, common cold, acute rhinosinusitis or acute cough/acute bronchitis." The NICE tells GPs to reassure patients that antibiotics are not needed immediately because they will make little difference to symptoms and may have side effects, and to do a clinical review if the RTI worsens or becomes prolonged.