There is little point in patients with sore throats taking antibiotics, the WONCA conference was told yesterday. Despite this, they are widely over-prescribed, and patients expected doctors to recommend them, according to two studies presented at the conference.
Dr John Macnamara, a Co Wexford GP, pointed out that taking antibiotics simply shortened symptoms by up to half a day compared to letting nature take its course.
A second study carried out by a Navan GP, Dr Niall Maguire, showed that doctors prescribed antibiotics for up to 99 per cent of patients with sore throats even though they were probably necessary in only 10 per cent of cases.
Dr Macnamara said traditionally doctors prescribed antibiotics because of a fear people with strep throats would develop rheumatic fever. However, this was virtually eradicated in Ireland and there was a far higher risk of an allergic reaction to the antibiotic.
Dr Macnamara said the majority of throat infections were caused by viral infection, and antibiotics were only of use for fighting bacterial infection. "And even in the case of bacterial infection antibiotics only shorten symptoms up to 14 hours."
In Dr Macnamara's practice in New Ross, patients with sore throats, invited to take part in the study, were asked about their expectation of an antibiotic. Their actual likelihood of bacterial infection was then presented to them.
The study was also carried out in a second Co Wexford surgery. Of the patients told they were unlikely to have a strep throat, two-thirds disregarded the advice and still sought antibiotics. A number erroneously believed that the antibiotics did more than kill bacteria. They believed they had pain-killing properties and/or that they would suffer from complications if they did not get a prescription.
The second survey, to which 50 per cent of Irish GPs responded, found there was considerable pressure on family doctors to prescribe antibiotics. Dr Niall Maguire said patients often specified the type of antibiotic they wanted.
Dr Maguire said there was debate as to whether national guidelines were effective in altering prescribing practice. GPs see up to 300 cases of sore throat each year and prescribe an antibiotic in 90 per cent of cases.
"The decision to prescribe and the choice of antibiotic have economic implications as well as potential consequences on the emergence of antibiotic resistance," said Dr Maguire.