Older patients less likely to be prescribed antibiotics for common infections

Older people are less likely to be given antibiotics for common infections by their GP compared with younger adults, despite being at higher risk, a study suggests.

Academics called on GPs to “better target” antibiotics for those at greatest need after analysing data on millions of prescriptions.

There have been several measures introduced to try to reduce antibiotic use in order to tackle the growing threat of antimicrobial resistance.

But experts from the University of Manchester said that these measures had “not resulted in a greater likelihood of antibiotics being prescribed to patients with higher risks of infection-related hospital admissions”.

Researchers examined data on all adults registered with a GP in England who were diagnosed with upper respiratory, lower respiratory and urinary tract infections between 2019 and 2023.

More than 15 million diagnoses for these common infections were made during this time and some 10 million antibiotic prescriptions were made to treat these infections.

Academics found that older patients – those aged 75 or older – were “less likely to be prescribed antibiotics, despite being at higher risk of hospital admission”.

Compared with those aged 18 to 25, older adults were 31 per cent less likely to be prescribed antibiotics for an upper respiratory tract infection, according to the study, which has been published in the Journal of the Royal Society of Medicine.

‘Less need for antibiotics’

Dr Ali Fahmi, co-lead author of the study, said: “This is despite the fact that younger individuals are usually healthier and their bodies are more likely to handle a common infection by itself and, therefore, there is less need for antibiotics for them. Whereas older individuals are more likely to have other health problems and their bodies may not be able to handle a common infection without antibiotics.”

Researchers also found that some 450,000 people were admitted to hospital in the month following their diagnosis.

It was found that antibiotic prescribing was unrelated to the risk of hospital admission for lower respiratory tract or urinary tract infections, and there was only a “weak” link between hospital admission and prescription of an antibiotic for upper respiratory tract infections.

Prof Tjeerd van Staa, the co-lead author, added: “Given the threat of resistance, there is a need to better target antibiotics in primary care to patients with higher risks of infection-related complications such as sepsis.

“But this study finds that antibiotics for common infections are commonly not prescribed according to complication risk and that suggests there is plenty of scope to do more on reducing antibiotic prescribing.”

Commenting on the paper, Dr Michael Mulholland, honorary secretary of the Royal College of GPs, said: “GPs understand the dangers of infections becoming resistant to antibiotics, and over many years have taken steps to curb antibiotics prescribing where possible.

“As such, whilst antibiotics are an effective treatment against bacterial infections, GPs will not take the decision to prescribe them lightly, and are trained to do so only if they think it is in the best interests of the health of their patient, taking into account their individual circumstances and clinical guidance.”

He added: “What would be helpful is better access to tests to determine whether an infection is bacterial, and therefore antibiotics are more likely to be appropriate.”