Potential for reducing inappropriate antibiotic prescribing in English primary care

The Journal of Antimicrobial Chemotherapy
Timo SmieszekJulie V Robotham

Abstract

To identify and quantify inappropriate systemic antibiotic prescribing in primary care in England, and ultimately to determine the potential for reduction in prescribing of antibiotics. Primary care data from 2013-15 recorded in The Health Improvement Network (THIN) database were used. Potentially inappropriate prescribing events in the database were identified by: (i) comparing prescribing events against treatment guidelines; (ii) comparing actual proportions of consultations resulting in prescription for a set of conditions with the ideal proportions derived from expert opinion; and (iii) identifying high prescribers and their number of prescriptions above an age- and body-system-specific benchmark. Applying the most conservative assumptions, 8.8% of all systemic antibiotic prescriptions in English primary care were identified as inappropriate, and in the least conservative scenario 23.1% of prescriptions were inappropriate. All practices had non-zero reduction potentials, ranging from 6.4% to 43.5% in the middle scenario. The four conditions that contributed most to inappropriate prescribing were sore throat (23.0% of identified inappropriate prescriptions), cough (22.2%), sinusitis (7.6%) and acute otitis media (5.7%). One-...Continue Reading

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Mar 1, 2018·The Journal of Antimicrobial Chemotherapy·F Christiaan K DolkTimo Smieszek
Mar 1, 2018·The Journal of Antimicrobial Chemotherapy·Koen B PouwelsJulie V Robotham
Mar 1, 2018·The Journal of Antimicrobial Chemotherapy·Koen B PouwelsTimo Smieszek
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