Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Oct;59(567):e321-8.
doi: 10.3399/bjgp09X472610.

Reduced antibiotic prescribing for acute respiratory infections in adults and children

Sharon B Meropol  1 , Zhen Chen, Joshua P Metlay
Affiliations

Reduced antibiotic prescribing for acute respiratory infections in adults and children

Sharon B Meropol et al. Br J Gen Pract. 2009 Oct.

Abstract

Background: Recent public health efforts, including in the UK and US, have targeted decreasing unnecessary antibiotic use. In the US, prescribing for acute non-specific respiratory infections (ARIs) has decreased, but broad-spectrum antibacterial prescribing has soared.

Aim: To assess recent trends in antibacterial prescribing for ARIs in the UK.

Design of study: Retrospective cohort.

Setting: The Health Improvement Network database.

Method: Outpatient ARI visits from 1 January 1990 to 31 December 2004 were selected. Outcomes were antibacterial and broad-spectrum antibacterial prescriptions per thousand person-years, and the probability of receiving an antibacterial and broad-spectrum prescription conditional on an ARI visit.

Results: From 1990 to 2004, antibacterial prescribing rates for ARIs decreased from 55.0 to 30.3 prescriptions/1000 person-years for adults and from 124.8 to 46.3 prescriptions/1000 person-years for children (P=0.001). The probability of receiving an antibacterial prescription after an ARI visit decreased from 70.8% to 59.5% for adults and from 46.1% to 30.8% for children (P=0.003 and 0.007, respectively). Antibacterial prescribing declined faster for younger than for older adults. Broad-spectrum antibacterial prescribing rates decreased from 3.8 to 2.9 prescriptions/1000 person-years for adults and from 5.2 to 2.2 prescriptions/1000 person years for children (P=0.005 and 0.003, respectively). The probability of broad-spectrum prescribing did not demonstrate a significant linear trend for adults (P=0.16), and decreased for children (P=0.01).

Conclusion: UK antibacterial prescribing for ARIs has declined, similar to US trends, but there was no concomitant increase in low broad-spectrum prescribing. The success of UK strategies for limiting antimicrobial use has implications for programmes in other countries.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Adult and child visit rates per 1000 person-years.
Figure 2
Figure 2
Adult and child antibacterial prescribing rates per 1000 person-years.
Figure 3
Figure 3
Probability of antibacterial drug prescribing after ARI visit.
Figure 4
Figure 4
Broad-spectrum antibacterial drugs per 1000 person-years.
Figure 5
Figure 5
Probability of broad-spectrum antimicrobial drug prescribing after ARI visit.
See this image and copyright information in PMC

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.

References

    1. Lonks JR, Garau J, Gomez L, et al. Failure of macrolide antibiotic treatment in patients with bacteremia due to erythromycin-resistant Streptococcus pneumoniae. Clin Infect Dis. 2002;35(5):556–564. - PubMed
    1. Interagency Task Force on Antimicrobial Resistance. A public health action plan to combat antimicrobial resistance. Part 1: domestic issues. Atlanta: Interagency Task Force on Antimicrobial Resistance; 1999. http://www.cdc.gov/drugresistance/actionplan/index.htm (accessed 23 Mar 2009)
    1. Austrian R. Confronting drug-resistant pneumococci. Ann Intern Med. 1994;121(10):807–809. - PubMed
    1. Klugman KP. Pneumococcal resistance to antibiotics. Clin Microbiol Rev. 1990;3(2):171–196. - PMC - PubMed
    1. Metlay JP, Hofmann J, Cetron MS, et al. Impact of penicillin susceptibility on medical outcomes for adult patients with bacteremic pneumococcal pneumonia. Clin Infect Dis. 2000;30(3):520–528. - PubMed

Publication types