McCloskey, AP, Malabar, L, McCabe, PG, Gitsham, A and Jarman, I (2023) Antibiotic prescribing trends in primary care 2014–2022. Research in Social and Administrative Pharmacy. ISSN 1551-7411

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Abstract

Antimicrobial resistance (AMR) is a global healthcare challenge that governments and health systems are tackling primarily through antimicrobial stewardship (AMS). This should, improve antibiotic use, avoid inappropriate prescribing, reduce prescription numbers, aligning with national/international AMS targets. In primary care in the United Kingdom (UK) antibiotics are mainly prescribed for patients with urinary and respiratory symptoms (22.7% and 46% of all antibiotic prescriptions respectively). This study aimed to capture the time-series trends (2014–2022) for commonly prescribed antibiotics for respiratory and urinary tract infections in primary care in England. Trends for Amoxicillin, Amoxicillin sodium, Trimethoprim, Clarithromycin, Erythromycin, Erythromycin ethylsuccinate, Erythromycin stearate, Doxycycline hyclate, Doxycycline monohydrate and Phenoxymethylpenicillin (Penicillin V) were determined. In doing so providing evidence regarding meeting UK antibiotic prescribing rate objectives (a 15% reduction in human antibiotic use 2019–2024). Time series trend analysis of 62,949,272 antibiotic prescriptions from 6,370 General Practices in England extracted from the National Health Service (NHS) Business Services Authority web portal were explored. With additional investigation of prescribing rate trends by quintiles of the Index of Multiple Deprivation (IMD). Overall, there is a downwards trend in antibiotic prescribing for those explored. There is an association between IMD, geographical location, and higher antibiotic prescribing levels (prescribing hot spots). England has a well-documented North-South divide of health inequalities, this is reflected in antibiotic prescribing. The corona virus pandemic (COVID-19) impacted on AMS, with a rise in doxycycline and trimethoprim prescriptions notable in higher IMD areas. Since then, prescribing appears to have returned to pre-pandemic levels in all IMDs and continued to decline. AMS efforts are being adhered to in primary care in England. This study provides further evidence of the link between locality and poorer health outcomes (reflected in higher antibiotic prescribing). Further work is required to address antibiotic use in hot spot areas.

Item Type:	Article
Uncontrolled Keywords:	Antibiotics; Antimicrobial resistance; Health inequalities; Prescribing; Primary care; 1115 Pharmacology and Pharmaceutical Sciences; 1117 Public Health and Health Services; Pharmacology & Pharmacy
Subjects:	Q Science > QA Mathematics > QA75 Electronic computers. Computer science R Medicine > R Medicine (General) R Medicine > RM Therapeutics. Pharmacology
Divisions:	Computer Science & Mathematics Pharmacy & Biomolecular Sciences
Publisher:	Elsevier BV
SWORD Depositor:	A Symplectic
Date Deposited:	29 Jun 2023 13:16
Last Modified:	29 Jun 2023 13:16
DOI or ID number:	10.1016/j.sapharm.2023.05.001
URI:	https://researchonline.ljmu.ac.uk/id/eprint/20136

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