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Research article:
Antibiotic prescribing for common infections in UK general practice: variability and drivers
Reference:
Victoria Palin, Anna Mölter, Miguel Belmonte, Darren Ashcroft, Andrew White, William Welfare, Tjeerd van Staa(2018) Antibiotic prescribing for common infections in UK general practice: variability and drivers. Journal of Antimicrobial Chemotherapy, doi:
- Link to article
- Abstract
- Objectives: To examine variations across general practices and factors associated with antibiotic prescribing for common infections in UK primary care to identify potential targets for improvement and optimisation of prescribing. Methods: Oral antibiotics prescribing for common infections were analysed using anonymised UK primary care electronic health records between 2000 and 2015 using the Clinical Practice Research Datalink (CPRD). The rate of prescribing for each condition was observed over time and the correlation of prescribing between each condition estimated within a practice. Drivers of prescribing were estimated using logistic regression in a matched patient cohort (1:1 by age, sex and date). Results: Over 8 million patient records were examined in 587 general practices in the UK. Practices varied considerably in their propensity to prescribe antibiotics and this variance increased over time (except in cases of urinary tract infection (UTI)). Change points in prescribing did not reflect updates to national guidelines and prescribing for different infectious conditions varied within practices. A previous history of antibiotic use significantly increased the risk of receiving a subsequent antibiotic (by 22-48% for patients with ≥ 3 antibiotic prescriptions in the past 12 months), as did higher BMI, history of smoking and flu vaccinations. Other drivers for receiving an antibiotic varied considerably for each condition. Conclusions: Large variability in antibiotic prescribing between practices was observed. Prescribing guidelines alone do not positively influence a change in prescribing, suggesting more targeted interventions are required to optimise antibiotic prescribing in the UK.
- Author for correspondence
- Victoria Palin
- Email for correspondence
- victoria.palin@manchester.ac.uk
Code list: res70: Otitis externa
38 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 2D95.00 | Read | O/E - tympanic membrane red | diagnostic | res70: Otitis externa | |||
| F500.00 | Read | Perichondritis of pinna | diagnostic | res70: Otitis externa | |||
| F500000 | Read | Unspecified perichondritis of pinna | diagnostic | res70: Otitis externa | |||
| F500100 | Read | Acute perichondritis of pinna | diagnostic | res70: Otitis externa | |||
| F500200 | Read | Chronic pinna perichondritis | diagnostic | res70: Otitis externa | |||
| F500211 | Read | Chondrodermatitis nodularis helicis | diagnostic | res70: Otitis externa | |||
| F500300 | Read | Chondrodermatitis nodularis helicis | diagnostic | res70: Otitis externa | |||
| F500z00 | Read | Perichondritis of pinna NOS | diagnostic | res70: Otitis externa | |||
| F501.00 | Read | Infective otitis externa | diagnostic | res70: Otitis externa | |||
| F501000 | Read | Unspecified infective otitis externa | diagnostic | res70: Otitis externa | |||
| F501100 | Read | Acute infective otitis externa | diagnostic | res70: Otitis externa | |||
| F501111 | Read | Abscess, external ear | diagnostic | res70: Otitis externa | |||
| F501112 | Read | Cellulitis, external ear | diagnostic | res70: Otitis externa | |||
| F501200 | Read | Acute infection of pinna | diagnostic | res70: Otitis externa | |||
| F501300 | Read | Acute swimmers' ear | diagnostic | res70: Otitis externa | |||
| F501400 | Read | Infective otitis externa due to erysipelas | diagnostic | res70: Otitis externa | |||
| F501411 | Read | Erysipelas - otitis externa | diagnostic | res70: Otitis externa | |||
| F501700 | Read | Infective otitis externa due to impetigo | diagnostic | res70: Otitis externa | |||
| F501711 | Read | Impetigo - otitis externa | diagnostic | res70: Otitis externa | |||
| F501900 | Read | Other acute external ear infections | diagnostic | res70: Otitis externa | |||
| F501E00 | Read | Other chronic infective otitis externa | diagnostic | res70: Otitis externa | |||
| F501F00 | Read | Chronic infective otitis externa NOS | diagnostic | res70: Otitis externa | |||
| F501G00 | Read | Haemorrhagic otitis externa | diagnostic | res70: Otitis externa | |||
| F501y00 | Read | Other specified infective otitis externa | diagnostic | res70: Otitis externa | |||
| F501z00 | Read | Infective otitis externa NOS | diagnostic | res70: Otitis externa | |||
| F502.00 | Read | Other otitis externa | diagnostic | res70: Otitis externa | |||
| F502z00 | Read | Otitis externa NOS | diagnostic | res70: Otitis externa | |||
| F502z11 | Read | Inflammation ear external | diagnostic | res70: Otitis externa | |||
| F506.00 | Read | Abscess of external ear | diagnostic | res70: Otitis externa | |||
| F586.00 | Read | Otorrhoea | diagnostic | res70: Otitis externa | |||
| F586000 | Read | Unspecified otorrhoea | diagnostic | res70: Otitis externa | |||
| F586011 | Read | Discharging ear NOS | diagnostic | res70: Otitis externa | |||
| F586200 | Read | Otorrhagia | diagnostic | res70: Otitis externa | |||
| F586z00 | Read | Otorrhoea NOS | diagnostic | res70: Otitis externa | |||
| F587.00 | Read | Otalgia | diagnostic | res70: Otitis externa | |||
| F587000 | Read | Unspecified otalgia | diagnostic | res70: Otitis externa | |||
| F587.11 | Read | Ear pain | diagnostic | res70: Otitis externa | |||
| F587z00 | Read | Otalgia NOS | diagnostic | res70: Otitis externa |
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