TY - JOUR T1 - Reduced antibiotic prescribing for acute respiratory infections in adults and children JF - British Journal of General Practice JO - Br J Gen Pract SP - e321 LP - e328 DO - 10.3399/bjgp09X472610 VL - 59 IS - 567 AU - Sharon B Meropol AU - Zhen Chen AU - Joshua P Metlay Y1 - 2009/10/01 UR - http://bjgp.org/content/59/567/e321.abstract N2 - Background Recent public health efforts, including in the UK and US, have targeted decreasing unnecessary antibiotic use. In the US, prescribing for acute non-specific respiratory infections (ARIs) has decreased, but broad-spectrum antibacterial prescribing has soared.Aim To assess recent trends in antibacterial prescribing for ARIs in the UK.Design of study Retrospective cohort.Setting The Health Improvement Network database.Method Outpatient ARI visits from 1 January 1990 to 31 December 2004 were selected. Outcomes were antibacterial and broad-spectrum antibacterial prescriptions per thousand person-years, and the probability of receiving an antibacterial and broad-spectrum prescription conditional on an ARI visit.Results From 1990 to 2004, antibacterial prescribing rates for ARIs decreased from 55.0 to 30.3 prescriptions/1000 person-years for adults and from 124.8 to 46.3 prescriptions/1000 person-years for children (P = 0.001). The probability of receiving an antibacterial prescription after an ARI visit decreased from 70.8% to 59.5% for adults and from 46.1% to 30.8% for children (P = 0.003 and 0.007, respectively). Antibacterial prescribing declined faster for younger than for older adults. Broad-spectrum antibacterial prescribing rates decreased from 3.8 to 2.9 prescriptions/1000 person-years for adults and from 5.2 to 2.2 prescriptions/1000 person years for children (P = 0.005 and 0.003, respectively). The probability of broad-spectrum prescribing did not demonstrate a significant linear trend for adults (P = 0.16), and decreased for children (P = 0.01).Conclusion UK antibacterial prescribing for ARIs has declined, similar to US trends, but there was no concomitant increase in low broad-spectrum prescribing. The success of UK strategies for limiting antimicrobial use has implications for programmes in other countries. ER -