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Multicenter Study
. 2009 Oct;59(567):e315-20.
doi: 10.3399/bjgp09X472593.

Which practices are high antibiotic prescribers? A cross-sectional analysis

Kay Yee Wang  1 , Paul Seed, Peter Schofield, Saima Ibrahim, Mark Ashworth
Affiliations
Multicenter Study

Which practices are high antibiotic prescribers? A cross-sectional analysis

Kay Yee Wang et al. Br J Gen Pract. 2009 Oct.

Abstract

Background: Substantial variation in antibiotic prescribing rates between general practices persists, but remains unexplained at national level.

Aim: To establish the degree of variation in antibiotic prescribing between practices in England and identify the characteristics of practices that prescribe higher volumes of antibiotics.

Design of study: Cross-sectional study.

Setting: 8057 general practices in England.

Method: A dataset was constructed containing data on standardised antibiotic prescribing volumes, practice characteristics, patient morbidity, ethnicity, social deprivation, and Quality and Outcomes Framework achievement (2004-2005). Data were analysed using multiple regression modelling.

Results: There was a twofold difference in standardised antibiotic prescribing volumes between practices in the 10th and 90th centiles of the sample (0.48 versus 0.95 antibiotic prescriptions per antibiotic STAR-PU [Specific Therapeutic group Age-sex weightings-Related Prescribing Unit]). A regression model containing nine variables explained 17.2% of the variance in antibiotic prescribing. Practice location in the north of England was the strongest predictor of high antibiotic prescribing. Practices serving populations with greater morbidity and a higher proportion of white patients prescribed more antibiotics, as did practices with shorter appointments, non-training practices, and practices with higher proportions of GPs who were male, >45 years of age, and qualified outside the UK.

Conclusion: Practice and practice population characteristics explained about one-sixth of the variation in antibiotic prescribing nationally. Consultation-level and qualitative studies are needed to help further explain these findings and improve our understanding of this variation.

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Comment in

  • Respiratory infections.
    Howie J. Howie J. Br J Gen Pract. 2009 Dec;59(569):945. doi: 10.3399/bjgp09X473222. Br J Gen Pract. 2009. PMID: 20875264 Free PMC article. No abstract available.

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