Other considerations

Guidance

Medicines adherence may be a problem for some people taking medicines that need frequent dosing or longer treatment duration (for example, antibiotics). See the NICE guideline on medicines adherence.

Respiratory tract infections, including acute cough, are a common reason for consultations in primary care and for potential antibiotic prescribing. In a 2011 survey of UK primary care (Gulliford et al. 2014), consultations for 'cough and bronchitis' accounted for 39% of all consultations for respiratory tract infections, and the median practice issued an antibiotic prescription in 48% of these.
There is potential for resource savings if a no antibiotic or a back-up antibiotic prescription strategy is used. One systematic review (Spurling et al. 2017) found significantly lower antibiotic use with a back-up antibiotic prescribing strategy compared with immediate antibiotics, both when the back-up antibiotic prescription was given at the time of consultation (38.4% versus 86.8%; very low quality evidence) and when the prescription had to be collected on a separate visit (27.3% versus 95.3%; very low quality evidence).
Recommended antibiotics are all available as generic formulations, see Drug Tariff for costs.