Trends in antibiotic prescribing and associated indications in primary care from 1993 to 1997

Background Recent concerns that evidence on the appropriate use of antibiot ics is not having an impact on prescribing trends are based on UK prescribi ng data relating to 1980-1991. The aim of this paper is to determine trends in antibiotic prescribing from 1993 to 1997 and link antibiotic prescripti ons to diagnostic categories. Methods A retrospective analysis of antibiotic prescriptions linked to diag nostic codes was carried out using the West Midlands General Practice Resea rch Database. Results The prescribing rate for antibiotics fell from 963 prescriptions/10 00 patients in 1993 to 807 prescriptions/1000 patients in 1997 (p < 0.001). The proportion of antibiotic prescribing for respiratory conditions fell f rom 65 per cent in 1993 to 59 per cent in 1997 (p < 0.001). The main decrea ses in antibiotic prescribing are accounted for by non-specific lower respi ratory tract infections (-22 prescriptions/1000 patients), non-specific upp er respiratory tract infections (-21/1000 patients) and throat infections ( -20/1000 patients). There was increased prescribing for non-respiratory mis cellaneous conditions (+6 prescriptions/1000 patients). Conclusions Overall antibiotic prescribing declined by 16 per cent between 1993 and 1997, primarily for respiratory conditions. These results of the c urrent study are in marked contrast to an earlier review, which found an in crease of 46 per cent between 1980 and 1991 in England. The level of antibi otic prescribing for conditions which may not be bacterial in origin is sti ll high and there is scope for further reductions in antibiotic prescribing . This study highlights the need for regular epidemiological data to inform the debate on antibiotic prescribing.