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Manchester, UK – April 4, 2025 – A groundbreaking study conducted by epidemiologists at the University of Manchester has revealed alarmingly high levels of untargeted antibiotic prescribing for common infections. Analyzing 15.7 million patient records, the research, published today in the Journal of the Royal Society of Medicine, suggests that many antibiotics are being prescribed without adequate consideration of patient prognosis or the risk of infection worsening.
The study found that the likelihood of receiving antibiotics for lower respiratory tract or urinary tract infections showed little to no correlation with the patient’s risk of hospital admission. Similarly, the association between antibiotic prescriptions for upper respiratory tract infections and hospital admission risk was only weak.
Furthermore, the research indicated that patient characteristics, such as age and pre-existing health conditions, had a surprisingly weak influence on antibiotic prescribing decisions for common infections. Notably, elderly patients were 31% less likely to receive antibiotics for upper respiratory infections compared to younger patients, even though older individuals may be more vulnerable to complications. This suggests that younger patients are often prescribed antibiotics unnecessarily, contributing to the growing problem of antibiotic resistance, while older patients who might benefit from them are being overlooked.
“Antibiotics are effective in treating bacterial infections, but they carry the risks of antimicrobial resistance (AMR) and loss of effectiveness when used inappropriately,” said Professor Tjeerd van Staa, lead author of the study. “AMR has been recognized as one of the biggest threats to global public health. 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 to reduce antibiotic prescribing.”
The study also revealed that during the COVID-19 pandemic, the correlation between antibiotic prescriptions for lower respiratory infections and complication risk became even weaker, although changes for urinary tract infections were minor.
Dr. Ali Fahmi, another lead author, emphasized the need for a shift towards risk-based prescribing. “Rather than imposing targets for reducing inappropriate prescribing, we argue that it is far more viable for clinicians to focus on improving risk-based antibiotic prescribing for infections that are less severe and typically self-limiting,” he stated.
The researchers advocate for the integration of prognosis and harm considerations into treatment guidelines, along with enhanced personalized information for clinicians and patients to facilitate shared decision-making. A Knowledge Support System (KSS) developed by Professor van Staa, which provides tailored information to clinicians, is currently being tested in North-West England as a potential solution.
The research utilized anonymized patient-level electronic health records from the Phoenix Partnership (TPP) via the OpenSAFELY platform, encompassing data from general practices in England between January 2019 and March 2023.
Disclaimer: This news article is based on the provided research information and should not be taken as medical advice. Individuals with health concerns should always consult with a qualified healthcare professional for diagnosis and treatment. The findings of this study highlight potential areas for improvement in antibiotic prescribing practices, but further research and clinical validation are necessary to implement widespread changes.
