Antibiotic prescribing: the need for a policy in general practice

Abstract

Objective: To see whether changes in prescribing of oral antibacterials in Northern Ireland show the need for a community antibiotics policy.

Design: Analysis of prescribing totals for several oral antibiotics obtained retrospectively from the prescription pricing bureau for the years 1983-7.

Setting: Audit of anti-infective prescribing in general practice in Northern Ireland over five years.

Main outcome measure: Respective usage of agents defined as "common" and "occasional" in 1983.

Results: There was a gradual decrease in the relative use of common agents from 82% of the total in 1983 to 77% in 1987 together with a complementary increase in the use of occasional agents from 5% to 10%. Pronounced changes were noted in the use of amoxycillin, ampicillin, erythromycin, minocycline, doxycycline, and amoxycillin-clavulanic acid.

Conclusion: Though this survey found reasonably conservative prescribing, the trend towards increased use of occasional agents has both clinical and cost implications which could be addressed by the use of a prescribing formulary.