Background High levels of antibiotic prescribing are a major concern as they drive antimicrobial resistance. It is currently unknown whether practices that prescribe higher levels of antibiotics also prescribe more medicines in general. Aim To evaluate the relationship between antibiotic and general prescribing levels in primary care. Design and setting Cross-sectional study in 2014-2015 of 6517 general practices in England using NHS digital practice prescribing data (NHS-DPPD) for the main study, and of 587 general practices in the UK using the Clinical Practice Research Datalink for a replication study. Method Linear regression to assess determinants of antibiotic prescribing. Results NHS-DPPD practices prescribed an average of 576.1 antibiotics per 1000 patients per year (329.9 at the 5th percentile and 808.7 at the 95th percentile). The levels of prescribing of antibiotics and other medicines were strongly correlated. Practices with high levels of prescribing of other medicines (a rate of 27 159.8 at the 95th percentile) prescribed 80% more antibiotics than low-prescribing practices (rate of 8815.9 at the 5th percentile). After adjustment, NHS-DPPD practices with high prescribing of other medicines gave 60% more antibiotic prescriptions than lowprescribing practices (corresponding to higher prescribing of 276.3 antibiotics per 1000 patients per year). Prescribing of non-opioid painkillers and benzodiazepines were also strong indicators of the level of antibiotic prescribing. General prescribing levels were a much stronger driver for antibiotic prescribing than other risk factors, such as deprivation. Conclusion The propensity of GPs to prescribe medications generally is an important driver for antibiotic prescribing. Interventions that aim to optimise antibiotic prescribing will need to target general prescribing behaviours, in addition to specifically targeting antibiotics.
Bibliographical noteFunding Information:
Northern Health Science Alliance (NHSA) was awarded a grant by the Department of Health and Social Care to fund 'Health North Connected Health Cities'. NHSA awarded the University of Manchester as the Greater Manchester Connected Health City ('GMCHC') a grant to perform the allocated work.
Northern Health Science Alliance (NHSA) was awarded a grant by the Department of Health and Social Care to fund ‘Health North Connected Health Cities’. NHSA awarded the University of Manchester as the Greater Manchester Connected Health City (‘GMCHC’) a grant to perform the allocated work.
© British Journal of General Practice
- Drug prescribing
- General practice
- Non-opioid painkillers