Imperial College London
Alternate

Professor Toby Prevost

Faculty of Medicine, School of Public Health

Visiting Professor
 
 
 
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Contact

 

a.prevost

 
 
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Location

 

57Stadium HouseWhite City Campus

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Summary

 

Publications

Citation

BibTex format

@article{Gulliford:2016:10.1136/bmj.i3410,
author = {Gulliford, MC and Moore, MV and Little, P and Hay, AD and Fox, R and Prevost, AT and Juszczyk, D and Charlton, J and Ashworth, M},
doi = {10.1136/bmj.i3410},
journal = {BMJ: British Medical Journal},
title = {Safety of reduced antibiotic prescribing for self limiting respiratory tract infections in primary care: cohort study using electronic health records},
url = {http://dx.doi.org/10.1136/bmj.i3410},
volume = {354},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective To determine whether the incidence of pneumonia, peritonsillar abscess, mastoiditis, empyema, meningitis, intracranial abscess, and Lemierre’s syndrome is higher in general practices that prescribe fewer antibiotics for self limiting respiratory tract infections (RTIs).Design Cohort study.Setting 610 UK general practices from the UK Clinical Practice Research Datalink.Participants Registered patients with 45.5 million person years of follow-up from 2005 to 2014.Exposures Standardised proportion of RTI consultations with antibiotics prescribed for each general practice, and rate of antibiotic prescriptions for RTIs per 1000 registered patients.Main outcome measures Incidence of pneumonia, peritonsillar abscess, mastoiditis, empyema, meningitis, intracranial abscess, and Lemierre’s syndrome, adjusting for age group, sex, region, deprivation fifth, RTI consultation rate, and general practice.Results From 2005 to 2014 the proportion of RTI consultations with antibiotics prescribed decreased from 53.9% to 50.5% in men and from 54.5% to 51.5% in women. From 2005 to 2014, new episodes of meningitis, mastoiditis, and peritonsillar abscess decreased annually by 5.3%, 4.6%, and 1.0%, respectively, whereas new episodes of pneumonia increased by 0.4%. Age and sex standardised incidences for pneumonia and peritonsillar abscess were higher for practices in the lowest fourth of antibiotic prescribing compared with the highest fourth. The adjusted relative risk increases for a 10% reduction in antibiotic prescribing were 12.8% (95% confidence interval 7.8% to 17.5%, P<0.001) for pneumonia and 9.9% (5.6% to 14.0%, P<0.001) for peritonsillar abscess. If a general practice with an average list size of 7000 patients reduces the proportion of RTI consultations with antibiotics prescribed by 10%, then it might observe 1.1 (95% confidence interval 0.6 to 1.5) more cases of pneumonia each year and 0.9 (0.5 to 1.3) more cases of peritonsillar abscess each decade.
AU  - Gulliford,MC
AU  - Moore,MV
AU  - Little,P
AU  - Hay,AD
AU  - Fox,R
AU  - Prevost,AT
AU  - Juszczyk,D
AU  - Charlton,J
AU  - Ashworth,M
DO  - 10.1136/bmj.i3410
PY  - 2016///
SN  - 0959-8138
TI  - Safety of reduced antibiotic prescribing for self limiting respiratory tract infections in primary care: cohort study using electronic health records
T2  - BMJ: British Medical Journal
UR  - http://dx.doi.org/10.1136/bmj.i3410
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000379579600001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/71337
VL  - 354
ER  -
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