ArticleBMJ open2020
Serious bacterial infections and antibiotic prescribing in primary care: cohort study using electronic health records in the UK.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- A systematic review and meta-analysis to identify behavioural content and active ingredients of antimicrobial stewardship education and training interventions in hospital-based care settings.Antimicrobial resistance and infection control · 2025Pooled it
- Shivering has little diagnostic value in diagnosing serious bacterial infection in children: a systematic review and meta-analysis.European journal of pediatrics · 2021Pooled it
- Morbidity and patient characteristics on acute presentation with sore throat: a multicentre national audit.Annals of the Royal College of Surgeons of England · 2026Article
- Overview of Methods for Assessing Antimicrobial Use in Outpatient Settings in High-Income Countries: A Narrative Review.Antibiotics (Basel, Switzerland) · 2025Review
- A systematic review on how primary care electronic medical record data have been used for antimicrobial stewardship.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Review
- Hospitalizations and severe complications following acute sinusitis in general practice: a registry-based cohort study.The Journal of antimicrobial chemotherapy · 2023Article
- A qualitative interview study applying the COM-B model to explore how hospital-based trainers implement antimicrobial stewardship education and training in UK hospital-based care.BMC health services research · 2023Article
- Electronic Health Records and Antimicrobial Stewardship Research: a Narrative Review.Current epidemiology reports · 2022Review
- Burden of Serious Bacterial Infections and Multidrug-Resistant Organisms in an Adult Population of Nepal: A Comparative Analysis of Minimally Invasive Tissue Sampling Informed Mortality Surveillance of Community and Hospital Deaths.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Observational
- Antimicrobial stewardship in the UK during the COVID-19 pandemic: a population-based cohort study and interrupted time-series analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Article
- The Primary Care Perspective on the Norwegian National Strategy against Antimicrobial Resistance.Antibiotics (Basel, Switzerland) · 2020Article
- Probability of sepsis after infection consultations in primary care in the United Kingdom in 2002-2017: Population-based cohort study and decision analytic model.PLoS medicine · 2020Article
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Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveThis study evaluated whether serious bacterial infections are more frequent at family practices with lower antibiotic prescribing rates.
designCohort study.
setting706 UK family practices in the Clinical Practice Research Datalink from 2002 to 2017.
participants10.1 million registered patients with 69.3 million patient-years' follow-up. EXPOSURES: All antibiotic prescriptions, subgroups of acute and repeat antibiotic prescriptions, and proportion of antibiotic prescriptions associated with specific-coded indications.
main outcome measuresFirst episodes of serious bacterial infections. Poisson models were fitted adjusting for age group, gender, comorbidity, deprivation, region and calendar year, with random intercepts representing family practice-specific estimates.
resultsThe age-standardised antibiotic prescribing rate per 1000 patient-years increased from 2002 (male 423; female 621) to 2012 (male 530; female 842) before declining to 2017 (male 449; female 753). The median family practice had an antibiotic prescribing rate of 648 per 1000 patient-years with 95% range for different practices of 430-1038 antibiotic prescriptions per 1000 patient-years. Specific coded indications were recorded for 58% of antibiotic prescriptions at the median family practice, the 95% range at different family practices was from 10% to 75%. There were 139 759 first episodes of serious bacterial infection. After adjusting for covariates and the proportion of coded consultations, there was no evidence that serious bacterial infections were lower at family practices with higher total antibiotic prescribing. The adjusted rate ratio for 20% higher total antibiotic prescribing was 1.03, (95% CI 1.00 to 1.06, p=0.074).
conclusionsWe did not find population-level evidence that family practices with lower total antibiotic prescribing might have more frequent occurrence of serious bacterial infections overall. Improving the recording of infection episodes has potential to inform better antimicrobial stewardship in primary care.
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