Objectives:

Patient pressure and difficulties in accessing laboratory facilities are often put forward as reasons for inappropriate antibiotic prescribing in the community. Community general practitioners (GPs) and patients were questioned to establish their perception of appropriate prescribing, the existence of resistance problems and the use of laboratory investigations to facilitate prescribing.

Methods:

The Grampian region of Scotland operates an accelerated bacteriology laboratory examination (ABLE) service, ensuring overnight processing of samples in order to allow informed antibiotic prescribing. During an audit of use of the service and of antibiotic prescribing, we distributed questionnaires to both GPs and patients. Questions related to attitudes and knowledge of antibiotic prescribing and resistance and feedback on the ABLE service. Results were entered in an Excel spreadsheet and analysed by SPSS.

Results:

A total of 49 GPs responded (response rate 90%). 89% thought that reducing prescribing reduces resistance but only 38% considered resistance a problem in their own practice. 92% used the ABLE service, but only 8% daily and 47% weekly. 67% said they combined the service with a delayed prescription. 53% thought it decreased antibiotic prescription rates.

701 patients were surveyed. 23% expected antibiotic for a sore throat, 36% for a chesty cough, 35% for earache and 17% for sinusitis. Notably, expectations were markedly lower for their children. 88% thought the ABLE service was a good idea. 50% thought resistance a big problem and 74% wanted more information on antibiotic resistance in the form of a leaflet.

Conclusions:

Acceptance of the ABLE service and awareness of antibiotic resistance was high.

Patient expectations of antibiotics were low compared with the literature and provide a good grounding for further improvements in antibiotic prescribing based on decreased patient pressure and increased use of ABLE. Both GPs and patients seem well placed to maintain recent improvements in antibiotic prescribing in the Grampian region.