ArticleBMC public health2020
An examination of trends in antibiotic prescribing in primary care and the association with area-level deprivation in England.
Article in BMC public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Diagnostic accuracy of point-of-care tests for acute respiratory infection: a systematic review of reviews.Health technology assessment (Winchester, England) · 2026Pooled it
- The intersection of the social determinants of health and antimicrobial resistance in human populations: a systematic review.BMJ global health · 2025Pooled it
- Pooled it
- Using a decision support tool to reduce inappropriate antibiotic use after a delayed prescription.Applied psychology. Health and well-being · 2026Trial
- Antibiotic prescribing in people with and without diabetes: a population-based matched cohort study.JAC-antimicrobial resistance · 2026Article
- Occurrence and Characterization of Antimicrobial-Resistant and VirulentAntibiotics (Basel, Switzerland) · 2026Article
- Parental awareness and management of antibiotic side effects and allergies in children and young people: a UK survey.JAC-antimicrobial resistance · 2026Article
- Antibiotic susceptibility patterns in US children's hospitals.Journal of hospital medicine · 2026Article
- Evaluating the implementation of a mental health joint response with young people and families: protocol for the care responders study, a realist and health economic evaluation.Frontiers in health services · 2026Article
- Association of factors linked to health inequalities and the risk of antibiotic-resistant infection in high-income countries: a systematic scoping review.JAC-antimicrobial resistance · 2025Review
- Antibiotic prescribing intensity and community UTI resistance: a cross-sectional ecological study.BJGP open · 2025Article
- Implementation of a National Antimicrobial Stewardship Training Programme for General Practice: A Case Study.Antibiotics (Basel, Switzerland) · 2025Article
- Article
- Recurrent urinary tract infections and prophylactic antibiotic use in women: a cross-sectional study in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Overprescribing of potentially harmful medication: an observational study in England's general practice.BJGP open · 2024Article
- Antimicrobial resistance prevalence in bloodstream infection in 29 European countries by age and sex: An observational study.PLoS medicine · 2024Observational
- Patterns of GP and nurse independent prescriber prescriptions for antibiotics dispensed in the community in England: a retrospective analysis.The Journal of antimicrobial chemotherapy · 2023Article
- Antibiotic prescribing in remote versus face-to-face consultations for acute respiratory infections in primary care in England: an observational study using target maximum likelihood estimation.EClinicalMedicine · 2023Article
- A scoping review and behavioural analysis of factors underlying overuse of antimicrobials.JAC-antimicrobial resistance · 2023Article
- A geospatial approach to identify patterns of antibiotic susceptibility at a neighborhood level in Wisconsin, United States.Scientific reports · 2023Observational
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Authors and funding
6 authors.
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Abstract
backgroundInternationally, there are growing concerns about antimicrobial resistance. This has resulted in increased scrutiny of antibiotic prescribing trends - particularly in primary care where the majority of prescribing occurs. In England, antibiotic prescribing targets are set nationally but little is known about the local context of antibiotic prescribing. This study aimed to examine trends in antibiotic prescribing (including broad-spectrum), and the association with area-level deprivation and region in England.
methodsAntibiotic prescribing data by GP surgery in England were obtained from NHS Business Service Authority for the years 2014-2018. These data were matched with the Index of Multiple Deprivation (IMD) 2015 at the Lower Layer Super Output Area level Lower Layer Super Output Area (LSOA) level. Linear regression methods were employed to explore the relationship between antibiotic use and area-level deprivation as well as region, after controlling for a range of other confounding variables, including health need, rurality, and ethnicity.
resultsOver time, the amount of antibiotic prescribing significantly reduced from 1.11 items per STAR-PU to 0.96 items per STAR-PU - a reduction of 13.6%. The adjusted models found that, at LSOA level, the most deprived areas of England had the highest levels of antibiotic prescribing (0.03 items per STAR-PU higher). However, broad spectrum antibiotic prescribing exceeding 10% of all antibiotic prescribing within a GP practice was higher in more affluent areas. There were also significant regional differences - with the North East and the East of England having the highest levels of antibiotic prescribing (by 0.16 items per STAR-PU).
conclusionAlthough antibiotic prescribing has reduced over time, there remains significant variation in by area-level deprivation and region in England - with higher antibiotic prescribing in more deprived areas. Future prescribing targets should account for local factors to ensure the most deprived communities are not inappropriately penalised.
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