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Journal of Public Health Advance Access published online on September 4, 2009
Journal of Public Health, doi:10.1093/pubmed/fdp081
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© The Author (2009). Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved.
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oupjournals.org

Selective decrease in consultations and antibiotic prescribing for acute respiratory tract infections in UK primary care up to 2006


Martin Gulliford, Professor of Public Health1
Radoslav Latinovic, Database Manager1
Judith Charlton, Research Associate1
Paul Little, Professor in Primary Care Research2
Tjeerd van Staa, Director of Research3,4
Mark Ashworth, Senior Lecturer in General Practice5

1 Department of Public Health Sciences, King's College London, Capital House, 42 Weston St, London SE1 3QD UK
2 Division of Community Clinical Sciences, University of Southampton, Southampton, UK
3 Division of General Practice Research Database, Medicines and Healthcare Products Regulatory Agency, London, UK
4 Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
5 Department of General Practice and Primary Care, King's College London, London, UK


Address correspondence to Martin Gulliford, E-mail: martin.gulliford{at}kcl.ac.uk


  Abstract

Background The aim of this study was to estimate trends in primary care consultations and antibiotic prescribing for acute respiratory tract infections (RTIs) in the UK from 1997 to 2006.

Methods Data were analysed for 100 000 subjects registered with 78 family practices in the UK General Practice Research Database; the numbers of consultations for RTI and associated antibiotic prescriptions were enumerated.

Results The consultation rate for RTI declined in females from 442.2 per 1000 registered patients in 1997 to 330.9 in 2006, and in males from 318.5 to 249.0. The rate of consultations for colds, rhinitis and upper respiratory tract infection (URTI) declined by 4.2 (95% CI 2.3–6.1) per 1000 per year in females and by 3.6 (2.3–4.8) in males. The rate of antibiotic prescribing for RTI was higher in females and declined by 8.5 (2.0–15.1) per 1000 in females and 6.7 (2.7–10.8) in males. For colds, rhinitis and URTI, the proportion of consultations with antibiotics was prescribed declined by 1.7% per year in females and 1.8% in males.

Conclusions Decreasing frequency of consultation and antibiotic prescription for colds, rhinitis and ‘URTI’ continues to drive a reduction in the rate of antibiotic utilization for RTIs.

Keywords: antibacterial agents, drug prescription, drug resistance, family practice, microbial, respiratory tract infections


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