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Research article:
Trends in antibiotic prescribing in primary care for clinical syndromes subject to national recommendations to reduce antibiotic resistance, UK 1995-2011: analysis of a large database of primary care consultations
Reference:
Jeremy I. Hawker; Sue Smith; Gillian E. Smith; Roger Morbey; Alan P. Johnson; Douglas M. Fleming; Laura Shallcross; Andrew C. Hayward(2014) Trends in antibiotic prescribing in primary care for clinical syndromes subject to national recommendations to reduce antibiotic resistance, UK 1995-2011: analysis of a large database of primary care consultations. Journal of Antimicrobial Chemotherapy, doi: 10.1093/jac/dku291
- Link to fulltext article
- Abstract
- Objectives To measure trends in antibiotic prescribing in UK primary care in relation to nationally recommended best practice. Patients and methods A descriptive study linking individual patient data on diagnosis and prescription in a large primary care database, covering 537 UK general practices during 1995–2011. Results The proportion of cough/cold episodes for which antibiotics were prescribed decreased from 47% in 1995 to 36% in 1999, before increasing to 51% in 2011. There was marked variation by primary care practice in 2011 [10th–90th percentile range (TNPR) 32%–65%]. Antibiotic prescribing for sore throats fell from 77% in 1995 to 62% in 1999 and then stayed broadly stable (TNPR 45%–78%). Where antibiotics were prescribed for sore throat, recommended antibiotics were used in 69% of cases in 2011 (64% in 1995). The use of recommended short-course trimethoprim for urinary tract infection (UTI) in women aged 16–74 years increased from 8% in 1995 to 50% in 2011; however, a quarter of practices prescribed short courses in ≤16% of episodes in 2011. For otitis media, 85% of prescriptions were for recommended antibiotics in 2011, increasing from 77% in 1995. All these changes in annual prescribing were highly statistically significant (P < 0.001). Conclusions The implementation of national guidelines in UK primary care has had mixed success, with prescribing for coughs/colds, both in total and as a proportion of consultations, now being greater than before recommendations were made to reduce it. Extensive variation by practice suggests that there is significant scope to improve prescribing, particularly for coughs/colds and for UTIs.
- Author for correspondence
- Jeremy I. Hawker
- Email for correspondence
- jeremy.hawker@phe.gov.uk
Code list: res20: Otitis media
28 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 2D94.00 | Read | O/E - tympanic membrane pink | diagnostic | res20: Otitis media | |||
| 2D95.00 | Read | O/E - tympanic membrane red | diagnostic | res20: Otitis media | |||
| 2D96.00 | Read | O/E - tympanic membrane bulging | diagnostic | res20: Otitis media | |||
| F51..00 | Read | Nonsuppurative otitis media + eustachian tube disorders | diagnostic | res20: Otitis media | |||
| F510.00 | Read | Acute non suppurative otitis media | diagnostic | res20: Otitis media | |||
| F510000 | Read | Acute otitis media with effusion | diagnostic | res20: Otitis media | |||
| F510011 | Read | Acute secretory otitis media | diagnostic | res20: Otitis media | |||
| F510100 | Read | Acute serous otitis media | diagnostic | res20: Otitis media | |||
| F510200 | Read | Acute mucoid otitis media | diagnostic | res20: Otitis media | |||
| F510z00 | Read | Acute nonsuppurative otitis media NOS | diagnostic | res20: Otitis media | |||
| F514.00 | Read | Unspecified nonsuppurative otitis media | diagnostic | res20: Otitis media | |||
| F514100 | Read | Serous otitis media NOS | diagnostic | res20: Otitis media | |||
| F514200 | Read | Catarrhal otitis media NOS | diagnostic | res20: Otitis media | |||
| F514300 | Read | Mucoid otitis media NOS | diagnostic | res20: Otitis media | |||
| F514z00 | Read | Nonsuppurative otitis media NOS | diagnostic | res20: Otitis media | |||
| F52..00 | Read | Suppurative and unspecified otitis media | diagnostic | res20: Otitis media | |||
| F520.00 | Read | Acute suppurative otitis media | diagnostic | res20: Otitis media | |||
| F520000 | Read | Acute suppurative otitis media tympanic membrane intact | diagnostic | res20: Otitis media | |||
| F520100 | Read | Acute suppurative otitis media tympanic membrane ruptured | diagnostic | res20: Otitis media | |||
| F520300 | Read | Acute suppurative otitis media due to disease EC | diagnostic | res20: Otitis media | |||
| F520z00 | Read | Acute suppurative otitis media NOS | diagnostic | res20: Otitis media | |||
| F524.00 | Read | Purulent otitis media NOS | diagnostic | res20: Otitis media | |||
| F524000 | Read | Bilateral suppurative otitis media | diagnostic | res20: Otitis media | |||
| F526.00 | Read | Acute left otitis media | diagnostic | res20: Otitis media | |||
| F527.00 | Read | Acute right otitis media | diagnostic | res20: Otitis media | |||
| F528.00 | Read | Acute bilateral otitis media | diagnostic | res20: Otitis media | |||
| F52z.00 | Read | Otitis media NOS | diagnostic | res20: Otitis media | |||
| F52z.11 | Read | Infection ear | diagnostic | res20: Otitis media |
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