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Antibiotic usage in chronic rhinosinusitis: analysis of national primary care electronic health records

Antibiotic usage in chronic rhinosinusitis: analysis of national primary care electronic health records
Antibiotic usage in chronic rhinosinusitis: analysis of national primary care electronic health records
Background
The aim of this study was to analyse rates of antibiotic usage in chronic rhinosinusitis (CRS) in primary care in England and Wales and to identify trends in the choice of antibiotics prescribed.
Methods
We used linked data from primary care EHRs, with diagnoses coded using the Read terminology (Clinical Practice Research Datalink) from consenting general practices, with (2) hospital care administrative records (Hospital Episode Statistics, HES recorded using ICD-10).

Results
From the total of 88,317 cases of CRS identified , 40,462 (46%) had an antibiotic prescription within 5 days of their first CRS diagnosis. Of patients receiving a first line antibiotic within 5 days of CRS diagnosis, over 80%, in each CRS group, received a subsequent prescription for an antibiotic . Within 5 years of diagnosis, 9% are estimated to have had 5 or more antibiotics within 5 days of a CRS-related consultation. With data spanning almost 20 years, it was possible to discern trends in antibiotics prescriptions, with a clear increasing trend towards macrolide and tetracycline prescribing evident.

Conclusions
While antibiotics may have been prescribed for acute exacerbations, we have found high rates of repeated antibiotic prescription in some patients with CRS in primary care. There is a need for stronger evidence on the role of antibiotics in CRS management.
0300-0729
Hopkins, Claire
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Williamson, Elizabeth
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Morris, Steve
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Clarke, Caroline S.
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Thomas, Mike
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Little, Paul
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Lund, Valerie J.
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Blackshaw, Helen
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Schilder, Anne G.M.
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Philpot, Carl
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Denaxas, Spiros
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Hopkins, Claire
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Williamson, Elizabeth
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Morris, Steve
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Clarke, Caroline S.
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Thomas, Mike
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Little, Paul
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Lund, Valerie J.
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Blackshaw, Helen
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Schilder, Anne G.M.
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Philpot, Carl
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Denaxas, Spiros
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Hopkins, Claire, Williamson, Elizabeth, Morris, Steve, Clarke, Caroline S., Thomas, Mike, Little, Paul, Lund, Valerie J., Blackshaw, Helen, Schilder, Anne G.M., Philpot, Carl and Denaxas, Spiros (2019) Antibiotic usage in chronic rhinosinusitis: analysis of national primary care electronic health records. Rhinology. (doi:10.4193/Rhin19.136).

Record type: Article

Abstract

Background
The aim of this study was to analyse rates of antibiotic usage in chronic rhinosinusitis (CRS) in primary care in England and Wales and to identify trends in the choice of antibiotics prescribed.
Methods
We used linked data from primary care EHRs, with diagnoses coded using the Read terminology (Clinical Practice Research Datalink) from consenting general practices, with (2) hospital care administrative records (Hospital Episode Statistics, HES recorded using ICD-10).

Results
From the total of 88,317 cases of CRS identified , 40,462 (46%) had an antibiotic prescription within 5 days of their first CRS diagnosis. Of patients receiving a first line antibiotic within 5 days of CRS diagnosis, over 80%, in each CRS group, received a subsequent prescription for an antibiotic . Within 5 years of diagnosis, 9% are estimated to have had 5 or more antibiotics within 5 days of a CRS-related consultation. With data spanning almost 20 years, it was possible to discern trends in antibiotics prescriptions, with a clear increasing trend towards macrolide and tetracycline prescribing evident.

Conclusions
While antibiotics may have been prescribed for acute exacerbations, we have found high rates of repeated antibiotic prescription in some patients with CRS in primary care. There is a need for stronger evidence on the role of antibiotics in CRS management.

Text
Antibiotic Usage in Chronic Rhinosinusitis - accepted changes - Accepted Manuscript
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Accepted/In Press date: 13 July 2019
e-pub ahead of print date: 6 September 2019

Identifiers

Local EPrints ID: 434796
URI: http://eprints.soton.ac.uk/id/eprint/434796
ISSN: 0300-0729
PURE UUID: f1d891a7-dbe1-4824-a304-c14929a05e39
ORCID for Paul Little: ORCID iD orcid.org/0000-0003-3664-1873

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Date deposited: 09 Oct 2019 16:30
Last modified: 12 Jul 2024 01:35

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Contributors

Author: Claire Hopkins
Author: Elizabeth Williamson
Author: Steve Morris
Author: Caroline S. Clarke
Author: Mike Thomas
Author: Paul Little ORCID iD
Author: Valerie J. Lund
Author: Helen Blackshaw
Author: Anne G.M. Schilder
Author: Carl Philpot
Author: Spiros Denaxas

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