Publication

Duration of antibiotic treatment for common infections in English primary care: cross sectional analysis and comparison with guidelines

Pouwels, K. B., Hopkins, S., Llewelyn, M. J., Walker, A. S., McNulty, C. A. M. & Robotham, J. V., 27-Feb-2019, In : BMJ-British Medical Journal. 364, 8189, 9 p., 440.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Pouwels, K. B., Hopkins, S., Llewelyn, M. J., Walker, A. S., McNulty, C. A. M., & Robotham, J. V. (2019). Duration of antibiotic treatment for common infections in English primary care: cross sectional analysis and comparison with guidelines. BMJ-British Medical Journal, 364(8189), [440]. https://doi.org/10.1136/bmj.l440

Author

Pouwels, Koen B. ; Hopkins, Susan ; Llewelyn, Martin J. ; Walker, Ann Sarah ; McNulty, Cliodna A. M. ; Robotham, Julie V. / Duration of antibiotic treatment for common infections in English primary care : cross sectional analysis and comparison with guidelines. In: BMJ-British Medical Journal. 2019 ; Vol. 364, No. 8189.

Harvard

Pouwels, KB, Hopkins, S, Llewelyn, MJ, Walker, AS, McNulty, CAM & Robotham, JV 2019, 'Duration of antibiotic treatment for common infections in English primary care: cross sectional analysis and comparison with guidelines', BMJ-British Medical Journal, vol. 364, no. 8189, 440. https://doi.org/10.1136/bmj.l440

Standard

Duration of antibiotic treatment for common infections in English primary care : cross sectional analysis and comparison with guidelines. / Pouwels, Koen B.; Hopkins, Susan; Llewelyn, Martin J.; Walker, Ann Sarah; McNulty, Cliodna A. M.; Robotham, Julie V.

In: BMJ-British Medical Journal, Vol. 364, No. 8189, 440, 27.02.2019.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Pouwels KB, Hopkins S, Llewelyn MJ, Walker AS, McNulty CAM, Robotham JV. Duration of antibiotic treatment for common infections in English primary care: cross sectional analysis and comparison with guidelines. BMJ-British Medical Journal. 2019 Feb 27;364(8189). 440. https://doi.org/10.1136/bmj.l440


BibTeX

@article{248156a8b3a4486abdebff3bc6f8a68e,
title = "Duration of antibiotic treatment for common infections in English primary care: cross sectional analysis and comparison with guidelines",
abstract = "OBJECTIVETo evaluate the duration of prescriptions for antibiotic treatment for common infections in English primary care and to compare this with guideline recommendations.DESIGNCross sectional study.SETTINGGeneral practices contributing to The Health Improvement Network database, 2013-15.PARTICIPANTS931 015 consultations that resulted in an antibiotic prescription for one of several indications: acute sinusitis, acute sore throat, acute cough and bronchitis, pneumonia, acute exacerbation of chronic obstructive pulmonary disease (COPD), acute otitis media, acute cystitis, acute prostatitis, pyelonephritis, cellulitis, impetigo, scarlet fever, and gastroenteritis.MAIN OUTCOME MEASURESThe main outcomes were the percentage of antibiotic prescriptions with a duration exceeding the guideline recommendation and the total number of days beyond the recommended duration for each indication.RESULTSThe most common reasons for antibiotics being prescribed were acute cough and bronchitis (386 972, 41.6{\%} of the included consultations), acute sore throat (239 231, 25.7{\%}), acute otitis media (83 054, 8.9{\%}), and acute sinusitis (76 683, 8.2{\%}). Antibiotic treatments for upper respiratory tract indications and acute cough and bronchitis accounted for more than two thirds of the total prescriptions considered, and 80{\%} or more of these treatment courses exceeded guideline recommendations. Notable exceptions were acute sinusitis, where only 9.6{\%} (95{\%} confidence interval 9.4{\%} to 9.9{\%}) of prescriptions exceeded seven days and acute sore throat where only 2.1{\%} (2.0{\%} to 2.1{\%}) exceeded 10 days (recent guidance recommends five days). More than half of the antibiotic prescriptions were for longer than guidelines recommend for acute cystitis among females (54.6{\%}, 54.1{\%} to 55.0{\%}). The percentage of antibiotic prescriptions exceeding the recommended duration was lower for most non-respiratory infections. For the 931 015 included consultations resulting in antibiotic prescriptions, about 1.3 million days were beyond the durations recommended by guidelines.CONCLUSIONFor most common infections treated in primary care, a substantial proportion of antibiotic prescriptions have durations exceeding those recommended in guidelines. Substantial reductions in antibiotic exposure can be accomplished by aligning antibiotic prescription durations with guidelines.",
keywords = "RESPIRATORY-TRACT INFECTION, RISK, AMOXICILLIN, PHYSICIANS, RESISTANCE, PNEUMONIA",
author = "Pouwels, {Koen B.} and Susan Hopkins and Llewelyn, {Martin J.} and Walker, {Ann Sarah} and McNulty, {Cliodna A. M.} and Robotham, {Julie V.}",
year = "2019",
month = "2",
day = "27",
doi = "10.1136/bmj.l440",
language = "English",
volume = "364",
journal = "British Medical Journal",
issn = "0959-8138",
publisher = "BMJ PUBLISHING GROUP",
number = "8189",

}

RIS

TY - JOUR

T1 - Duration of antibiotic treatment for common infections in English primary care

T2 - cross sectional analysis and comparison with guidelines

AU - Pouwels, Koen B.

AU - Hopkins, Susan

AU - Llewelyn, Martin J.

AU - Walker, Ann Sarah

AU - McNulty, Cliodna A. M.

AU - Robotham, Julie V.

PY - 2019/2/27

Y1 - 2019/2/27

N2 - OBJECTIVETo evaluate the duration of prescriptions for antibiotic treatment for common infections in English primary care and to compare this with guideline recommendations.DESIGNCross sectional study.SETTINGGeneral practices contributing to The Health Improvement Network database, 2013-15.PARTICIPANTS931 015 consultations that resulted in an antibiotic prescription for one of several indications: acute sinusitis, acute sore throat, acute cough and bronchitis, pneumonia, acute exacerbation of chronic obstructive pulmonary disease (COPD), acute otitis media, acute cystitis, acute prostatitis, pyelonephritis, cellulitis, impetigo, scarlet fever, and gastroenteritis.MAIN OUTCOME MEASURESThe main outcomes were the percentage of antibiotic prescriptions with a duration exceeding the guideline recommendation and the total number of days beyond the recommended duration for each indication.RESULTSThe most common reasons for antibiotics being prescribed were acute cough and bronchitis (386 972, 41.6% of the included consultations), acute sore throat (239 231, 25.7%), acute otitis media (83 054, 8.9%), and acute sinusitis (76 683, 8.2%). Antibiotic treatments for upper respiratory tract indications and acute cough and bronchitis accounted for more than two thirds of the total prescriptions considered, and 80% or more of these treatment courses exceeded guideline recommendations. Notable exceptions were acute sinusitis, where only 9.6% (95% confidence interval 9.4% to 9.9%) of prescriptions exceeded seven days and acute sore throat where only 2.1% (2.0% to 2.1%) exceeded 10 days (recent guidance recommends five days). More than half of the antibiotic prescriptions were for longer than guidelines recommend for acute cystitis among females (54.6%, 54.1% to 55.0%). The percentage of antibiotic prescriptions exceeding the recommended duration was lower for most non-respiratory infections. For the 931 015 included consultations resulting in antibiotic prescriptions, about 1.3 million days were beyond the durations recommended by guidelines.CONCLUSIONFor most common infections treated in primary care, a substantial proportion of antibiotic prescriptions have durations exceeding those recommended in guidelines. Substantial reductions in antibiotic exposure can be accomplished by aligning antibiotic prescription durations with guidelines.

AB - OBJECTIVETo evaluate the duration of prescriptions for antibiotic treatment for common infections in English primary care and to compare this with guideline recommendations.DESIGNCross sectional study.SETTINGGeneral practices contributing to The Health Improvement Network database, 2013-15.PARTICIPANTS931 015 consultations that resulted in an antibiotic prescription for one of several indications: acute sinusitis, acute sore throat, acute cough and bronchitis, pneumonia, acute exacerbation of chronic obstructive pulmonary disease (COPD), acute otitis media, acute cystitis, acute prostatitis, pyelonephritis, cellulitis, impetigo, scarlet fever, and gastroenteritis.MAIN OUTCOME MEASURESThe main outcomes were the percentage of antibiotic prescriptions with a duration exceeding the guideline recommendation and the total number of days beyond the recommended duration for each indication.RESULTSThe most common reasons for antibiotics being prescribed were acute cough and bronchitis (386 972, 41.6% of the included consultations), acute sore throat (239 231, 25.7%), acute otitis media (83 054, 8.9%), and acute sinusitis (76 683, 8.2%). Antibiotic treatments for upper respiratory tract indications and acute cough and bronchitis accounted for more than two thirds of the total prescriptions considered, and 80% or more of these treatment courses exceeded guideline recommendations. Notable exceptions were acute sinusitis, where only 9.6% (95% confidence interval 9.4% to 9.9%) of prescriptions exceeded seven days and acute sore throat where only 2.1% (2.0% to 2.1%) exceeded 10 days (recent guidance recommends five days). More than half of the antibiotic prescriptions were for longer than guidelines recommend for acute cystitis among females (54.6%, 54.1% to 55.0%). The percentage of antibiotic prescriptions exceeding the recommended duration was lower for most non-respiratory infections. For the 931 015 included consultations resulting in antibiotic prescriptions, about 1.3 million days were beyond the durations recommended by guidelines.CONCLUSIONFor most common infections treated in primary care, a substantial proportion of antibiotic prescriptions have durations exceeding those recommended in guidelines. Substantial reductions in antibiotic exposure can be accomplished by aligning antibiotic prescription durations with guidelines.

KW - RESPIRATORY-TRACT INFECTION

KW - RISK

KW - AMOXICILLIN

KW - PHYSICIANS

KW - RESISTANCE

KW - PNEUMONIA

U2 - 10.1136/bmj.l440

DO - 10.1136/bmj.l440

M3 - Article

VL - 364

JO - British Medical Journal

JF - British Medical Journal

SN - 0959-8138

IS - 8189

M1 - 440

ER -

ID: 77804766