(Understanding the culture of prescribing: qualitative study of general practitioners' and patients' perceptions of antibiotics for sore throats)

General practitioners are increasingly prescribing antibiotics for patients with sore throats in spite of growing clinical evidence that these drugs alleviate symptoms only slightly, if at all. The choice of treatment is affected by both the patient's expectations and what the doctor perceives the patient expects. Over-prescription of antibiotics is a major concern as it has been correlated with the increasing prevalence of antibiotic-resistant bacteria.

In this week's BMJ, Dr Christopher Butler and colleagues from the University of Wales College of Medicine report the findings of a survey which illustrates some of the cultural reasons why doctors prescribe antibiotics or non-antibiotics, based on interviews with GPs and patients in South Wales.

Dr Butler et al report that the prescribing decision is very much influenced by the doctor-patient relationship, but that patient satisfaction was not necessarily related to receiving a prescription for antibiotics. Both doctors and patients emphasised the importance of educating patients about the appropriate use of antibiotics, and two thirds of patients gained satisfaction from receiving information and reassurance from their GPs. Doctors were divided about the possible benefits of a national campaign to educate the public, but saw the value of educating patients individually.

Contact:

Dr Stephen Rollnick, Senior Lecturer in General Practice, Department of General Practice, University of Wales College of Medicine, Llanedeyrn Health Centre, Maelfa, Cardiff