Telephone GP appointments are driving a worrying rise in antibiotic prescriptions which could put lives at-risk, experts are warning.
The bacteria-fighting medicines are crucial for clearing infections and preventing life-threatening complications. However, hard-to-treat cases are on the rise as the bacteria that cause them are becoming increasingly impervious to the drugs.
Over the past decade, the NHS has made a concerted effort to reduce the number of antibiotic prescriptions given to patients, in order to slow the spread of superbugs.
Yet, the number is on the rise again, with nearly 37 million prescriptions written last year, compared to 36 million in 2022 and 31 million in 2020, official figures show.
The number of antibiotic prescriptions is on the rise again, with nearly 37 million written last year, compared to 36 million in 2022 and 31 million in 2020
Now experts say that fewer face-to-face GP appointments across the NHS could be a major factor behind the increase, as research suggests that patients seen remotely are significantly more likely to be prescribed antibiotics.
They also warn that the number of antibiotics being doled out could be significantly higher than the data suggests because many people turn to private GPs for care – and their prescriptions are not included in the government figures.
‘The rise in antibiotic prescriptions is a concerning trend and something needs to be done to stop it,’ says Dr Ryan Hamilton, associate professor of antimicrobials at De Montfort University, Leicester.
‘Remote GP appointments aren’t the sole cause of the increase, but there is good evidence that they are a contributor.’
The World Health Organisation warns that, by 2050, superbug infections could lead to 10 million deaths across the globe each year.
In England, 58,000 people acquire an antibiotic-resistant infection every year.
Almost 8,000 people in the UK die from such infections annually. In 2013, in response to the looming crisis, the then Chief Medical Officer, Dame Sally Davies, cracked down on the number of NHS antibiotic prescriptions.
Her focus was primarily on GPs and she took the extreme measure in 2015 of sending warning letters to thousands of family doctors deemed to be ‘overprescribing’ antibiotics.
Dame Sally also accused family doctors of bowing to pressure from ‘anxious’ patients and prescribing antibiotics for mild conditions such as coughs and colds despite the drugs being ineffective against them.
Her efforts were successful, with the number of NHS antibiotic prescriptions falling from 43 million in 2012 to a low of 31million during the Covid pandemic in 2020.
However, since then number have risen. Experts say there are several possible reasons.
It’s been suggested, for example, that, as infections become harder to treat, more antibiotics are needed to treat them – as a single course won’t be effective.
Nevertheless, a growing number of experts believe this rise in antibiotic prescriptions is directly linked to the reduction in face-to-face appointments which has occurred since the pandemic.
Since 2019, the annual number of remote GP appointments has risen by about 40 per cent, with most taking place over the phone.
Last year, research by NHS England and the charity The Health Foundation concluded that virtual appointments were more likely to result in an antibiotic prescription being issued.
An illustration of bacterial transduction, the mechanism that can lead to antimicrobial resistance
The research, published in the journal eClinical Medicine, found that patients presenting with cold and flu symptoms were 25 per cent more likely to get antibiotics if seen remotely compared to those treated in person.
Experts say that remote appointments lead to a higher rate of antibiotic use because GPs are more ‘uncertain’ about the diagnosis.
‘When GPs see patients remotely, there is more guesswork because they can’t carry out a physical examination,’ says Dr Nisa Aslam, a Watford-based GP.
‘If a doctor saw a patient with respiratory symptoms in-person, she might check his oxygen levels to make sure his condition wasn’t getting worse or listen to his lungs using a stethoscope for signs of a bacterial infection.
‘But, over the phone, you can’t do this. So doctors are more likely to offer antibiotics “just in case”.’
One patient who knows the danger of drug-resistant infections is Vanessa Carter, 45, from Devon, who caught the MRSA superbug in hospital after being injured in a car crash in 2004.
‘It was a ten-year battle to clear the MRSA,’ says the mother-of-one, who now works with the charity Antibiotic Research UK as a patient advocate.
‘That’s why it’s so important that we do everything to limit the number of antibiotics we take, otherwise more patients will suffer like I did.’
