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. 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.

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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.

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