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GP antibiotic prescribing decreases slower in older patients and those without indication, study finds

Research has shown that although the rate of antibiotic presciption is declining, it is declining more slowly in patients over the age of 55 years and prescriptions being given without clinical indication is still a cause for concern.

antibiotic packets


A study published in BMJ Open has found that although antibiotic stewardship is having an impact, “substantial unnecessary antibiotic use may persist”

Antibiotic prescribing by GPs declined consistently between 2014 and 2017, but the rate of decline was lower in patients over the age of 55 years old, study results published in BMJ Open show (9 July 2019).

Researchers from King’s College London analysed data from 102 GPs in England from between 2014 and 2017, and evaluated prescriptions for all antibiotics.

They found that total antibiotic prescribing declined from 608 prescriptions per 1,000 person-years in 2014 to 489 per 1,000 person-years in 2017 a decline of 19.6%. Prescribing of broad-spectrum antibiotics decreased by 9.3% per year, from 221 per 1,000 person-years in 2014 to 163 in 2017. This suggested a move towards more targeted narrow-spectrum substitutions, the researchers said.

Overall declines in antibiotic prescribing were similar for men and women, but the rate of decline was lower in people over the age of 55 years than it was for younger patients.

The most frequently issued antibiotics were penicillin, macrolides and tetracyclines.

In terms of individual conditions, it was found that antibiotic prescribing rates for respiratory conditions decreased the most, at a rate of 9.8% per year. This was followed by genitourinary infections, which fell by 5.7% per year. The lowest decrease in antibiotic prescribing was for when no indication was recorded.

The researchers noted that more than half of antibiotic prescriptions were documented without specific clinical conditions recorded.

“Antibiotic prescribing has reduced and become more selective, but substantial unnecessary antibiotic use may persist,” said Xiaohui Sun, lead researcher on the study.

“Improving the quality of diagnostic coding for antibiotic use will help to support antimicrobial stewardship.”

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206779

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