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Community-acquired pneumonia mortality: a potential link to antibiotic prescribing trends in general practice

Community-acquired pneumonia mortality: a potential link to antibiotic prescribing trends in general practice
Community-acquired pneumonia mortality: a potential link to antibiotic prescribing trends in general practice

Background: community prescribing of antibiotics has decreased substantially in the UK in recent years. We examine the association between pneumonia mortality and recent changes in community-based antibiotic prescribing for lower respiratory tract infections (LRTI).

Methods: retrospective analysis of aggregated data for pneumonia mortality, influenza incidence, and antibiotic prescribing for LRTI in England and Wales during 12-week winter periods between 1993/94 and 1999/2000.

Results: winter antibiotic prescribing for LRTI showed a 30.0% decline since 1995/96. Over the same period, there was a 50.6% increase in winter excess pneumonia mortality adjusted for influenza incidence. Negative binomial regression analysis showed that the incidence of influenza alone had a significant association with winter pneumonia mortality (P<0.001). The analysis also showed the reduction in antibiotic prescribing had a small but significant association with mortality (P<0.001), when simultaneously modelling for influenza incidence.

Conclusions: our findings suggest an association between recent reductions in antibiotic prescribing for LRTI in general practice and an increase in pneumonia mortality in England and Wales. This retrospective study of aggregate data represents the first attempt to assess the effect of limiting antibiotic prescribing on patient outcomes, and highlights the need to identify which patients benefit from antibiotic treatment for LRTI.

Anti-Bacterial Agents, Community-Acquired Infections, England, Family Practice, Humans, Incidence, Influenza, Human, Mortality, Pneumonia, Practice Patterns, Physicians', Regression Analysis, Retrospective Studies, Risk Factors, Seasons, Wales, Journal Article, Research Support, Non-U.S. Gov't
0954-6111
17-24
Price, David B
3b39783f-ac9e-4cab-85d3-25d4c5cbbd23
Honeybourne, David
067794fa-f895-4a9f-84bf-89299a2c3bdd
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Mayon-White, Richard T
ef9557ae-b972-4fc9-a0a0-fa99d5eecbf7
Read, Robert C
b5caca7b-0063-438a-b703-7ecbb6fc2b51
Thomas, Mike
d05fc21a-7f09-45d8-b6f6-2ed740db8c23
Wale, Martin C
26b4f0a3-7b69-4e58-869d-ad9700ffe1d7
FitzGerald, Patrick
ec788e2d-2520-45b6-87d2-ef8f7266f3ae
Weston, Adèle R
64ded006-6c97-42a6-9003-54daf9842c72
Winchester, Christopher C
2fa2fc83-6297-4589-bfe0-74a91faebce6
Price, David B
3b39783f-ac9e-4cab-85d3-25d4c5cbbd23
Honeybourne, David
067794fa-f895-4a9f-84bf-89299a2c3bdd
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Mayon-White, Richard T
ef9557ae-b972-4fc9-a0a0-fa99d5eecbf7
Read, Robert C
b5caca7b-0063-438a-b703-7ecbb6fc2b51
Thomas, Mike
d05fc21a-7f09-45d8-b6f6-2ed740db8c23
Wale, Martin C
26b4f0a3-7b69-4e58-869d-ad9700ffe1d7
FitzGerald, Patrick
ec788e2d-2520-45b6-87d2-ef8f7266f3ae
Weston, Adèle R
64ded006-6c97-42a6-9003-54daf9842c72
Winchester, Christopher C
2fa2fc83-6297-4589-bfe0-74a91faebce6

Price, David B, Honeybourne, David, Little, Paul, Mayon-White, Richard T, Read, Robert C, Thomas, Mike, Wale, Martin C, FitzGerald, Patrick, Weston, Adèle R and Winchester, Christopher C (2004) Community-acquired pneumonia mortality: a potential link to antibiotic prescribing trends in general practice. Respiratory Medicine, 98 (1), 17-24.

Record type: Article

Abstract

Background: community prescribing of antibiotics has decreased substantially in the UK in recent years. We examine the association between pneumonia mortality and recent changes in community-based antibiotic prescribing for lower respiratory tract infections (LRTI).

Methods: retrospective analysis of aggregated data for pneumonia mortality, influenza incidence, and antibiotic prescribing for LRTI in England and Wales during 12-week winter periods between 1993/94 and 1999/2000.

Results: winter antibiotic prescribing for LRTI showed a 30.0% decline since 1995/96. Over the same period, there was a 50.6% increase in winter excess pneumonia mortality adjusted for influenza incidence. Negative binomial regression analysis showed that the incidence of influenza alone had a significant association with winter pneumonia mortality (P<0.001). The analysis also showed the reduction in antibiotic prescribing had a small but significant association with mortality (P<0.001), when simultaneously modelling for influenza incidence.

Conclusions: our findings suggest an association between recent reductions in antibiotic prescribing for LRTI in general practice and an increase in pneumonia mortality in England and Wales. This retrospective study of aggregate data represents the first attempt to assess the effect of limiting antibiotic prescribing on patient outcomes, and highlights the need to identify which patients benefit from antibiotic treatment for LRTI.

Full text not available from this repository.

More information

Accepted/In Press date: 20 August 2003
e-pub ahead of print date: 22 October 2003
Published date: January 2004
Keywords: Anti-Bacterial Agents, Community-Acquired Infections, England, Family Practice, Humans, Incidence, Influenza, Human, Mortality, Pneumonia, Practice Patterns, Physicians', Regression Analysis, Retrospective Studies, Risk Factors, Seasons, Wales, Journal Article, Research Support, Non-U.S. Gov't

Identifiers

Local EPrints ID: 416422
URI: https://eprints.soton.ac.uk/id/eprint/416422
ISSN: 0954-6111
PURE UUID: 7aa403d2-7978-4c1a-9a17-83ea750766e6
ORCID for Robert C Read: ORCID iD orcid.org/0000-0002-4297-6728

Catalogue record

Date deposited: 15 Dec 2017 17:30
Last modified: 09 Aug 2019 00:33

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