Can GPs really be blamed for the overuse of antibiotics?

GPs across the country have come under fierce criticism from a leading NICE figure for prescribing too many antibiotics.

Resistance by bacteria to antibiotics has for a long time been a concern and is often penned as a potential threat to the human race. As more and more bacteria become resistant to our best and most advance medicines, the threat to human health grows, with the risk that previously eradicated infections could return. Not only does this pose a threat to those suffering from bacterial infection directly, but it could lead to the reduction of surgical procedures and chemotherapy if the risk of infection cannot be adequately controlled.

The cause of bacterial resistance is thought to be the over use of antibiotics, prescribed by GPs for illnesses as trivial as a sore throat and the common cold. Professor Baker from NICE revealed that 97% of patients who attend their GP asking for antibiotics are prescribed them, and that frequent attendees who are often “addicted” to taking antibiotics identify those “soft-touch” GPs who will dispense antibiotics on demand, even when they are not clinically indicated.

This is concerning, as a very simplistic view could go as far as to say that the practice by such GPs is actually harming human health.

It is these GP’s that Professor Baker would like to be targeted, and he proposes that intervention by the General Medical Council, which has the power to strip a GP of their right to practice medicine, should be used a deterrent and punishment for over-prescribing. A system that monitors the number of prescriptions would most likely be used to identify those GPs who may be prescribing outside of the guidelines, and they would then be investigated in more detail.

But are “soft touch” GPs really the true driver behind drug resistance or are we as patients and society as a whole responsible for the increasing pressures placed on those doctors to supply medication?

Dr Tim Ballard from the Royal College of GPs seems to think that the root of the issue rests with all of us. He suggests a need for “societal change” and urges that “any suggestion that hard-pressed GPs – who are already trying to do their jobs in increasingly difficult circumstances – will be reported to the regulator is counter-productive and unhelpful”.

Looking at society, there has without a doubt been a shift in people’s reliance on healthcare and medicines. Our parents and grandparents recall a time when you only went to see a doctor when you physically could not do anything else. Most people turned to “home remedies” and made full recoveries from common bacterial illness without the need for clinical intervention. Nowadays, GPs are under increasing pressure to see record numbers of patients, who may all too freely visit their GP with a simple cold. The exact cause of this shift in thinking is not known, but it could be that increasing access to medical information online, the pressures placed on healthy living and busy working habits that do not allow time for illness may all be factors that drive patients to their GP looking for a quick fix.

There is an expectation today that when visiting a GP if a diagnosis is reached that some sort of prescription will be given to help the patient. Many patients are unsatisfied if advised to simply keep hydrated and rest and today’s announcement suggests that those patients will keep re-attending and taking up valuable appointments until they are given a course of antibiotics. GPs must strike a balance between their obligation to control the prescription of antibiotics and running an efficient GP practice, and some GPs may feel they have no choice but to pander to needy patients in order to get them out of the door.

NICE has announced that it will be publishing guidelines in 2016 on how to educate the public on antibiotic use, but until then it does admit that if it’s own pre-existing guidance to GPs was being followed, the number of antibiotic prescription would be 22% lower; 42 million.

Perhaps we all need to take responsibility for what could ultimately be a huge leap backwards in medicine and mankind, if our antibiotics begin to fail us?

Author: James Edmondson