ArticleAntimicrobial resistance and infection control2023
The impact of the COVID-19 pandemic on the treatment of common infections in primary care and the change to antibiotic prescribing in England.
Article in Antimicrobial resistance and infection control, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Antibiotic prescribing in people with and without diabetes: a population-based matched cohort study.JAC-antimicrobial resistance · 2026Article
- Primary care pharyngotonsillitis complications following absent or deferred antibiotic treatment across the COVID 19 pandemic.Communications medicine · 2026Article
- National retrospective study of regional prescriber-specific variation in community antibiotic prescribing Canada, 2019-2023.BMJ public health · 2026Article
- Remote versus in-person consultations for acute cystitis: antibiotic treatment and clinical outcomes, a retrospective cohort study.BJGP open · 2025Article
- Ocular Antibiotic Use in Young Danish Children From 2016 to 2024.Basic & clinical pharmacology & toxicology · 2025Article
- Beyond the pandemic: rising administrative demands and changing disease profiles in primary care.Israel journal of health policy research · 2025Article
- The Impact of Point-of-Care Testing for Influenza on Antimicrobial Stewardship in UK Primary Care: Nested Cohort Study.JMIR public health and surveillance · 2025Article
- Antibiotic prescribing intensity and community UTI resistance: a cross-sectional ecological study.BJGP open · 2025Article
- The impact of the COVID-19 pandemic on antibiotic prescription rates in out-of-hours primary care - a register-based study in Denmark.Scandinavian journal of primary health care · 2025Article
- Examining the impact of treatment guidelines on outpatient antibiotic prescription trends at a cancer center in Pakistan.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- 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
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Authors and funding
14 authors.
Funding
Abstract
backgroundThere is concern that the COVID-19 pandemic altered the management of common infections in primary care. This study aimed to evaluate infection-coded consultation rates and antibiotic use during the pandemic and how any change may have affected clinical outcomes.
methodsWith the approval of NHS England, a retrospective cohort study using the OpenSAFELY platform analysed routinely collected electronic health data from GP practices in England between January 2019 and December 2021. Infection coded consultations and antibiotic prescriptions were used estimate multiple measures over calendar months, including age-sex adjusted prescribing rates, prescribing by infection and antibiotic type, infection consultation rates, coding quality and rate of same-day antibiotic prescribing for COVID-19 infections. Interrupted time series (ITS) estimated the effect of COVID-19 pandemic on infection-coded consultation rates. The impact of the pandemic on non- COVID-19 infection-related hospitalisations was also estimated.
resultsRecords from 24 million patients were included. The rate of infection-related consultations fell for all infections (mean reduction of 39% in 2020 compared to 2019 mean rate), except for UTI which remained stable. Modelling infection-related consultation rates highlighted this with an incidence rate ratio of 0.44 (95% CI 0.36-0.53) for incident consultations and 0.43 (95% CI 0.33-0.54) for prevalent consultations. Lower respiratory tract infections (LRTI) saw the largest reduction of 0.11 (95% CI 0.07-0.17). Antibiotic prescribing rates fell with a mean reduction of 118.4 items per 1000 patients in 2020, returning to pre-pandemic rates by summer 2021. Prescribing for LRTI decreased 20% and URTI increased 15.9%. Over 60% of antibiotics were issued without an associated same-day infection code, which increased during the pandemic. Infection-related hospitalisations reduced (by 62%), with the largest reduction observed for pneumonia infections (72.9%). Same-day antibiotic prescribing for COVID-19 infection increased from 1 to 10.5% between the second and third national lockdowns and rose again during 2022.
conclusionsChanges to consultations and hospital admissions may be driven by reduced transmission of non-COVID-19 infections due to reduced social mixing and lockdowns. Inconsistencies in coding practice emphasises the need for improvement to inform new antibiotic stewardship policies and prevent resistance to novel infections.
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