Data from the Clinical Practice Research Datalink (CPRD) show a substantial drop in GP antibiotic prescribing, although the reduction has been less significant in patients aged above 55 years and those with no clear diagnosis.
Using CPRD data from 2014 to 2017, researchers at King’s College London analysed prescriptions for all antibiotics and for broad-spectrum β-lactam antibiotics for 102 general practices in England.
They found that total antibiotic prescribing declined from 608 prescriptions per 1000 person-years in 2014 to 489 per 1000 person-years in 2017, representing a relative rate reduction (RRR) of 6.9 per cent (95% CI, 6.6%-7.1%) per year.
Broad-spectrum β-lactam antibiotic prescribing decreased from 221 per 1000 person-years in 2014 to 163 per 1000 person-years in 2017, demonstrating an RRR of 9.3 per cent (95% CI, 9.0%-9.6%) per year.
Declines in antibiotic prescribing were similar for men and women, but the rate of decline was lower in patients over the age of 55 years than for younger patients.
All antibiotic prescribing declined by 9.8 per cent (95% CI, 9.6%-10.1%) per year for respiratory infections and 5.7 per cent (95% CI, 5.2%-6.2%) for genitourinary infections. However, the decline was just 3.8 per cent (95% CI, 3.1%-4.5%) for cases with no recorded indication.
Overall, 38.8 per cent of antibiotic prescriptions were associated with codes that did not suggest specific clinical conditions, and 15.3 per cent of prescriptions had no medical codes recorded.
The authors concluded that GP antibiotic prescribing has reduced and become more selective, but they say substantial unnecessary use may still persist. They say improving the quality of diagnostic coding for antibiotic use will help to support antimicrobial stewardship efforts.