Evidence map›Paper›PMID 37182748›Full record

ArticleThe Journal of infection2023

The impact of COVID-19 on antibiotic prescribing in primary care in England: Evaluation and risk prediction of appropriateness of type and repeat prescribing.

Xiaomin Zhong, Alexander Pate, Ya-Ting Yang, Ali Fahmi, Darren M Ashcroft, Ben Goldacre, Brian MacKenna, Amir Mehrkar, Sebastian C J Bacon, Jon Massey and 6 more

Open access · hybridAbstract read

PubMed Full text at PMC Publisher

In one paragraph

Article in The Journal of infection, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it

0cells of the map it votes in

7citing papers in PubMed

2.9field-weighted citation impact, top 7% of its field

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 16 citations in OpenAlex.

Barriers and facilitators to implementing antimicrobial stewardship (AMS) in a Chinese tertiary hospital: a qualitative study based on the Consolidated Framework for Implementation Research (CFIR).BMC infectious diseases · 2026
Article
Barriers and facilitators of the implementation for the antimicrobial Social Norm Feedback (SNF) intervention strategy in primary care institutions: a qualitative study based on the Consolidated Framework for Implementation Research (CFIR).Antimicrobial resistance and infection control · 2025
Article
Risk of emergency hospital admission related to adverse events after antibiotic treatment in adults with a common infection: impact of COVID-19 and derivation and validation of risk prediction models.BMC medicine · 2024
Article
Exploring Prior Antibiotic Exposure Characteristics for COVID-19 Hospital Admission Patients: OpenSAFELY.Antibiotics (Basel, Switzerland) · 2024
Article
The impact of the COVID-19 pandemic on the treatment of common infections in primary care and the change to antibiotic prescribing in England.Antimicrobial resistance and infection control · 2023
Article
Knowledge support for optimising antibiotic prescribing for common infections in general practices: evaluation of the effectiveness of periodic feedback, decision support during consultations and peer comparisons in a cluster randomised trial (BRIT2) - study protocol.BMJ open · 2023
Article
A Time-varying Analysis of General Practice Prescribing in the COVID-19 Era: Lessons from Prescription Dynamics in a Pandemic.In vivo (Athens, Greece)
Article

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 3 institutions in 1 country.

Xiaomin ZhongCentre for Health Informatics, School of Health Sciences, Faculty of Biology, Medicine, and Health, the University of Manchester, M13 9PL, UK.

Alexander PateCentre for Health Informatics, School of Health Sciences, Faculty of Biology, Medicine, and Health, the University of Manchester, M13 9PL, UK.

Ya-Ting YangCentre for Health Informatics, School of Health Sciences, Faculty of Biology, Medicine, and Health, the University of Manchester, M13 9PL, UK.

Ali FahmiCentre for Health Informatics, School of Health Sciences, Faculty of Biology, Medicine, and Health, the University of Manchester, M13 9PL, UK.

Darren M AshcroftCentre for Pharmacoepidemiology and Drug Safety, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester M13 9PL, UK; NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester M13 9PL, UK.

Ben GoldacreBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG, UK.

Brian MacKennaBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG, UK; NHS England, Wellington House, Waterloo Road, London SE1 8UG, UK.

Amir MehrkarBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG, UK.

Sebastian C J BaconBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG, UK.

Jon MasseyBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG, UK.

Louis FisherBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG, UK.

Peter InglesbyBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG, UK.

OpenSAFELY collaborativeBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG, UK.

Kieran HandPharmacy Department, Portsmouth Hospitals University NHS Trust, Portsmouth, UK; NHS England, Wellington House, Waterloo Road, London SE1 8UG, UK.

Tjeerd van StaaCentre for Health Informatics, School of Health Sciences, Faculty of Biology, Medicine, and Health, the University of Manchester, M13 9PL, UK. Electronic address: tjeerd.vanstaa@manchester.ac.uk.

Victoria PalinCentre for Health Informatics, School of Health Sciences, Faculty of Biology, Medicine, and Health, the University of Manchester, M13 9PL, UK; Maternal and Fetal Research Centre, Division of Developmental Biology and Medicine, the University of Manchester, St Marys Hospital, Oxford Road, Manchester M13 9WL, UK.

Manchester Academic Health Science Centre · GBUniversity of Oxford · GBPublic Health England · GB

Funding

Medical Research Council MC_PC_20058Medical Research Council MC_PC_20059Medical Research Council MR/V015737/1Medical Research Council MR/W016729/1Wellcome Trust

6 · The paper itself

Abstract

backgroundThis study aimed to predict risks of potentially inappropriate antibiotic type and repeat prescribing and assess changes during COVID-19.

methodsWith the approval of NHS England, we used OpenSAFELY platform to access the TPP SystmOne electronic health record (EHR) system and selected patients prescribed antibiotics from 2019 to 2021. Multinomial logistic regression models predicted patient's probability of receiving inappropriate antibiotic type or repeat antibiotic course for each common infection.

resultsThe population included 9.1 million patients with 29.2 million antibiotic prescriptions. 29.1% of prescriptions were identified as repeat prescribing. Those with same day incident infection coded in the EHR had considerably lower rates of repeat prescribing (18.0%) and 8.6% had potentially inappropriate type. No major changes in the rates of repeat antibiotic prescribing during COVID-19 were found. In the 10 risk prediction models, good levels of calibration and moderate levels of discrimination were found.

conclusionsOur study found no evidence of changes in level of inappropriate or repeat antibiotic prescribing after the start of COVID-19. Repeat antibiotic prescribing was frequent and varied according to regional and patient characteristics. There is a need for treatment guidelines to be developed around antibiotic failure and clinicians provided with individualised patient information.

Indexed as

COVID-19Respiratory Tract InfectionsAnti-Bacterial AgentsEnglandHumansInappropriate PrescribingPrimary Health CareAnti-Bacterial AgentsAntibioticsAntibiotic stewardshipCOVID-19 pandemicInfectionPrimary care

Identifiers

PMID37182748

DOI10.1016/j.jinf.2023.05.010

PMCPMC10176893

OpenAlexW4376256776

What OpenQuestion holds

Textmetadata

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.