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


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.

SUBMITTER: Shallcross L 

PROVIDER: S-EPMC5437523 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Publications

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

Shallcross Laura L   Beckley Nick N   Rait Greta G   Hayward Andrew A   Petersen Irene I  

The Journal of antimicrobial chemotherapy 20170601 6


<h4>Background</h4>Reducing inappropriate antibiotic prescribing in primary care is a public health priority.<h4>Objectives</h4>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.<h4>Methods</h4>This was a cohort study using electronic health records from 1 948 390 adults registered with 385 primary care  ...[more]

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