Imperial College London
Alternate

PROFESSOR AZEEM MAJEED

Faculty of Medicine, School of Public Health

Chair - Primary Care and Public Health & Head of Department
 
 
 
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Contact

 

+44 (0)20 7594 3368a.majeed Website

 
 
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Assistant

 

Ms Dorothea Cockerell +44 (0)20 7594 3368

 
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Location

 

Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Aliabadi:2021:10.1016/S1473-3099(21)00069-4,
author = {Aliabadi, S and Anyanwu, P and Beech, E and Jauneikaite, E and Wilson, P and Hope, R and Majeed, A and Muller-Pebody, B and Costelloe, C},
doi = {10.1016/S1473-3099(21)00069-4},
journal = {Lancet Infectious Diseases},
title = {Effect of antibiotic stewardship interventions in primary care on antimicrobial resistance of Escherichia coli bacteraemia in England (2013-18): a quasi-experimental, ecological, data linkage study},
url = {http://dx.doi.org/10.1016/S1473-3099(21)00069-4},
volume = {21},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Antimicrobial resistance is a major global health concern, driven by overuse of antibiotics. We aimed to assess the effectiveness of a national antimicrobial stewardship intervention, the National Health Service (NHS) England Quality Premium implemented in 2015-16, on broad-spectrum antibiotic prescribing and Escherichia coli bacteraemia resistance to broad-spectrum antibiotics in England. METHODS: In this quasi-experimental, ecological, data linkage study, we used longitudinal data on bacteraemia for patients registered with a general practitioner in the English National Health Service and patients with E coli bacteraemia notified to the national mandatory surveillance programme between Jan 1, 2013, and Dec 31, 2018. We linked these data to data on antimicrobial susceptibility testing of E coli from Public Health England's Second-Generation Surveillance System. We did an ecological analysis using interrupted time-series analyses and generalised estimating equations to estimate the change in broad-spectrum antibiotics prescribing over time and the change in the proportion of E coli bacteraemia cases for which the causative bacteria were resistant to each antibiotic individually or to at least one of five broad-spectrum antibiotics (co-amoxiclav, ciprofloxacin, levofloxacin, moxifloxacin, ofloxacin), after implementation of the NHS England Quality Premium intervention in April, 2015. FINDINGS: Before implementation of the Quality Premium, the rate of antibiotic prescribing for all five broad-spectrum antibiotics was increasing at rate of 0·2% per month (incidence rate ratio [IRR] 1·002 [95% CI 1·000-1·004], p=0·046). After implementation of the Quality Premium, an immediate reduction in total broad-spectrum antibiotic prescribing rate was observed (IRR 0·867 [95% CI 0·837-0·898], p<0·0001). This effect was sustained until the end of the study period; a 57% reduction in rate of antibiotic pr
AU  - Aliabadi,S
AU  - Anyanwu,P
AU  - Beech,E
AU  - Jauneikaite,E
AU  - Wilson,P
AU  - Hope,R
AU  - Majeed,A
AU  - Muller-Pebody,B
AU  - Costelloe,C
DO  - 10.1016/S1473-3099(21)00069-4
PY  - 2021///
SN  - 1473-3099
TI  - Effect of antibiotic stewardship interventions in primary care on antimicrobial resistance of Escherichia coli bacteraemia in England (2013-18): a quasi-experimental, ecological, data linkage study
T2  - Lancet Infectious Diseases
UR  - http://dx.doi.org/10.1016/S1473-3099(21)00069-4
UR  - https://www.ncbi.nlm.nih.gov/pubmed/34363774
UR  - https://www.sciencedirect.com/science/article/pii/S1473309921000694?via%3Dihub/';/;'/;'
UR  - http://hdl.handle.net/10044/1/91921
VL  - 21
ER  -
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