Image copyright Science Photo Library Image caption As many as half of all antibiotics prescribed may be given out inappropriately by GPs in England

GPs who prescribe fewer antibiotics have less satisfied patients, according to a new study by researchers at King's College London.

The study, published in the British Journal of General Practice, compared the prescribing rates of more than 95% of all GP surgeries in England to a survey of patient satisfaction.

Those satisfaction scores are used to determine how much GPs get paid.

Patients' satisfaction rose when they were listened to or carefully examined.

A study last year warned that up to half of all prescriptions of antibiotics could be inappropriate - given to patients suffering coughs, colds, sore throats and the flu - none of which can be treated with antibiotics.

The overuse of antibiotics has led to antibiotic resistance, when bacteria and infections can no longer be killed off or treated with strong drugs.

In this study, doctors who prescribed 25% fewer antibiotics saw a modest reduction in patient satisfaction with them or with their surgery.

The General Practice Patient Survey, which invites nearly three million adults registered with GPs in England to comment on the quality of their care every year, is also a factor taken into account in GPs' performance-related pay.

Dr Mark Ashworth, GP and lead study author, from the King's College London division of health and social care research, said: "GPs often feel pressured by patients to prescribe antibiotics and find it difficult to refuse a patient who asks for them.

"GPs who are frugal in their antibiotic prescribing may need support to maintain patient satisfaction."

Although the authors say they can't show cause and effect in this study, other studies in other countries have come up with similar results.

But they also point to research that indicates it is possible to offset any feelings of dissatisfaction if patients feel they have been listened to or carefully examined.

Dr Tim Ballard, vice chair of the Royal College of GPs, said the findings were concerning.

"It is frustrating that GP practices that are working hard to reduce inappropriate antibiotics prescribing face falling patient satisfaction ratings.

"It truly is a case of being damned if we do and damned if we don't.

He added: "Public perception needs to change - our patients need to understand that when diseases become resistant to antibiotics, it means that antibiotics will cease to work and as it stands, we don't have an alternative.