Objectives:
To examine variations across general practices and factors associated with antibiotic prescribing for common infections in UK primary care to identify potential targets for improvement and optimization of prescribing.
Methods:
Oral antibiotic prescribing for common infections was analysed using anonymized UK primary care electronic health records between 2000 and 2015 using the Clinical Practice Research Datalink (CPRD). The rate of prescribing for each condition was observed over time and mean change points were compared with national guideline updates. Any correlation between the rate of prescribing for each infectious condition was estimated within a practice. Predictors of prescribing were estimated using logistic regression in a matched patient cohort (1:1 by age, sex and calendar time).
Results:
Over 8 million patient records were examined in 587 UK general practices. Practices varied considerably in their propensity to prescribe antibiotics and this variance increased over time. Change points in prescribing did not reflect updates to national guidelines. Prescribing levels within practices were not consistent for different infectious conditions. A history of antibiotic use significantly increased the risk of receiving a subsequent antibiotic (by 22%–48% for patients with three or more antibiotic prescriptions in the past 12months), as did higher BMI, history of smoking and flu vaccinations. Other drivers for receiving an antibiotic varied considerably for each condition.
Conclusions:
Large variability in antibiotic prescribing between practices and within practices was observed. Prescribing guidelines alone do not positively influence a change in prescribing, suggesting more targeted interventions are required to optimize antibiotic prescribing in the UK.
Victoria Palin, Anna Molter, Darren M Ashcroft, Andrew White, William Welfare, Tjeerd van Staa, Antibiotic prescribing for common infections in UK general practice variability and drivers. Journal of Antimicrobial Chemotherapy, 74:2440-2450, 2019.
Code | Description | Entity type | Category | Coding System (Read) |
---|---|---|---|---|
A552.00 | Postmeasles otitis media | res70: Otitis media | diagnostic | Read |
F51..00 | Nonsuppurative otitis media + eustachian tube disorders | res70: Otitis media | diagnostic | Read |
F510.00 | Acute non suppurative otitis media | res70: Otitis media | diagnostic | Read |
F510000 | Acute otitis media with effusion | res70: Otitis media | diagnostic | Read |
F510011 | Acute secretory otitis media | res70: Otitis media | diagnostic | Read |
F510100 | Acute serous otitis media | res70: Otitis media | diagnostic | Read |
F510200 | Acute mucoid otitis media | res70: Otitis media | diagnostic | Read |
F510300 | Acute sanguinous otitis media | res70: Otitis media | diagnostic | Read |
F510z00 | Acute nonsuppurative otitis media NOS | res70: Otitis media | diagnostic | Read |
F511.00 | Chronic otitis media with effusion, serous | res70: Otitis media | diagnostic | Read |
F511.11 | Chronic secretory otitis media, serous | res70: Otitis media | diagnostic | Read |
F511z00 | Chronic serous otitis media NOS | res70: Otitis media | diagnostic | Read |
F512.00 | Chronic otitis media with effusion, mucoid | res70: Otitis media | diagnostic | Read |
F512.11 | Glue ear | res70: Otitis media | diagnostic | Read |
F512.12 | Chronic secretory otitis media, mucoid | res70: Otitis media | diagnostic | Read |
F512000 | Glue ear, unspecified | res70: Otitis media | diagnostic | Read |
F512z00 | Chronic mucoid otitis media NOS | res70: Otitis media | diagnostic | Read |
F513.00 | Chronic otitis media with effusion, other | res70: Otitis media | diagnostic | Read |
F513100 | Chronic otitis media with effusion, purulent | res70: Otitis media | diagnostic | Read |
F513111 | Chronic secretory otitis media, purulent | res70: Otitis media | diagnostic | Read |
F514.00 | Unspecified nonsuppurative otitis media | res70: Otitis media | diagnostic | Read |
F514100 | Serous otitis media NOS | res70: Otitis media | diagnostic | Read |
F514200 | Catarrhal otitis media NOS | res70: Otitis media | diagnostic | Read |
F514300 | Mucoid otitis media NOS | res70: Otitis media | diagnostic | Read |
F514z00 | Nonsuppurative otitis media NOS | res70: Otitis media | diagnostic | Read |
F515.00 | Eustachian tube salpingitis | res70: Otitis media | diagnostic | Read |
F515.11 | Catarrh - eustachian | res70: Otitis media | diagnostic | Read |
F52..00 | Suppurative and unspecified otitis media | res70: Otitis media | diagnostic | Read |
F520.00 | Acute suppurative otitis media | res70: Otitis media | diagnostic | Read |
F520000 | Acute suppurative otitis media tympanic membrane intact | res70: Otitis media | diagnostic | Read |
F520100 | Acute suppurative otitis media tympanic membrane ruptured | res70: Otitis media | diagnostic | Read |
F520300 | Acute suppurative otitis media due to disease EC | res70: Otitis media | diagnostic | Read |
F520z00 | Acute suppurative otitis media NOS | res70: Otitis media | diagnostic | Read |
F521.00 | Chronic suppurative otitis media, tubotympanic | res70: Otitis media | diagnostic | Read |
F522.00 | Chronic suppurative otitis media, atticoantral | res70: Otitis media | diagnostic | Read |
F523.00 | Chronic suppurative otitis media NOS | res70: Otitis media | diagnostic | Read |
F524.00 | Purulent otitis media NOS | res70: Otitis media | diagnostic | Read |
F524000 | Bilateral suppurative otitis media | res70: Otitis media | diagnostic | Read |
F525.00 | Recurrent acute otitis media | res70: Otitis media | diagnostic | Read |
F526.00 | Acute left otitis media | res70: Otitis media | diagnostic | Read |
F527.00 | Acute right otitis media | res70: Otitis media | diagnostic | Read |
F528.00 | Acute bilateral otitis media | res70: Otitis media | diagnostic | Read |
F52z.00 | Otitis media NOS | res70: Otitis media | diagnostic | Read |
F52z.11 | Infection ear | res70: Otitis media | diagnostic | Read |
SN30.11 | Aero-otitis media | res70: Otitis media | diagnostic | Read |
To Export Phenotype Details:
Format | API |
---|---|
XML | site_root/api/v1/public/phenotypes/PH901/version/1881/detail/?format=xml |
JSON | site_root/api/v1/public/phenotypes/PH901/version/1881/detail/?format=json |
R Package |
|
To Export Phenotype Code List:
Format | API |
---|---|
XML | site_root/api/v1/public/phenotypes/PH901/version/1881/export/codes/?format=xml |
JSON | site_root/api/v1/public/phenotypes/PH901/version/1881/export/codes/?format=json |
CSV | site_root/phenotypes/PH901/version/1881/export/codes/ |
R Package |
|
Version ID |
Name | Owner | Publish date | |
---|---|---|---|---|
1881 | Otitis Media | ieuan.scanlon | 2022-04-04 | currently shown |
Export - export all codes into a csv file/JSON/XML for the current phenotype version.
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