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. 2017 Jun 1;72(6):1818-1824.
doi: 10.1093/jac/dkx048.

Antibiotic prescribing frequency amongst patients in primary care: a cohort study using electronic health records

Laura Shallcross  1 , Nick Beckley  2 , Greta Rait  2 , Andrew Hayward  1 , Irene Petersen  2   3
Affiliations

Antibiotic prescribing frequency amongst patients in primary care: a cohort study using electronic health records

Laura Shallcross et al. J Antimicrob Chemother. .

Abstract

Background: Reducing inappropriate antibiotic prescribing in primary care is a public health priority.

Objectives: We hypothesized that a subset of patients account for the majority of antibiotic prescriptions in primary care. We investigated the relationship between the total amount of antibiotics prescribed, individual-level antibiotic use and comorbidity.

Methods: This was a cohort study using electronic health records from 1 948 390 adults registered with 385 primary care practices in the UK in 2011-13. We estimated the average number of antibiotic prescriptions per patient and the association between prescribing and comorbidity. We modelled the impact on total prescribing of reducing antibiotic use in those prescribed antibiotics most frequently.

Results: On average 30.1% (586 194/1 948 390) of patients were prescribed at least one antibiotic per year. Nine percent (174 602/1 948 390) of patients were prescribed 53% (2 091 496/3 922 732) of the total amount of antibiotics, each of whom received at least five antibiotic prescriptions over 3 years. The presence of any comorbidity increased the prescribing rate by 44% [adjusted incidence rate ratio (IRR) 1.44, 95% CI 1.43-1.45]; rates of prescribing to women exceeded those in men by 62% (adjusted IRR 1.62, 95% CI 1.62-1.63).

Conclusions: Half of antibiotics prescribed to adults in primary care were for <10% of patients. Efforts to tackle antimicrobial resistance should consider the impact of this on total prescribing.

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Figures

Figure 1
Figure 1
Frequency of antibiotic use per patient over a 3 year period (2011–13). Forty-six percent of patients were not prescribed an antibiotic, but 7% received at least seven antibiotic prescriptions over the same time period.
Figure 2
Figure 2
Relationship between comorbidity and frequency of antibiotic prescribing per patient, 2011–13.
See this image and copyright information in PMC

References

    1. Department of Health. UK 5 Year Antimicrobial Resistance Strategy 2013 to 2018 https://www.gov.uk/government/publications/uk-5-year-antimicrobial-resis....
    1. Laxminarayan R, Matsoso P, Pant S. et al. Access to effective antimicrobials: a worldwide challenge. Lancet 2016; 387: 168–75. - PubMed
    1. WHO. Antimicrobial Resistance: Global Report on Surveillance 2014 http://www.who.int/drugresistance/documents/surveillancereport/en/.
    1. ECDC. Surveillance of Antimicrobial Consumption in Europe 2011 http://ecdc.europa.eu/en/publications/Publications/antimicrobial-consump....
    1. Hawker JI, Smith S, Smith GE. et al. 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. J Antimicrob Chemother 2014; 69: 3423–30. - PubMed

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