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Antibiotic prescribing is higher in deprived areas of England

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h6117 (Published 12 November 2015) Cite this as: BMJ 2015;351:h6117
  1. Jacqui Wise
  1. 1London

Prescribing of antibiotics has fallen steadily over the past five years in England, but the gap in prescribing levels between the least and most deprived areas is widening, a new analysis indicates.

The charity Antibiotic Research UK and the data analysis company EXASOL used prescribing data released by the government’s Health and Social Care Information Centre on the number of antibiotic prescriptions written by GPs and subsequently dispensed between August 2010 and July 2015. From the data they produced a “heat map” showing the hotspots of antibiotic prescribing in England (http://bit.ly/1krh7cZ).

Antibiotic prescriptions peaked in 2012, when a total of 3.8 million prescriptions were dispensed in England, but the number has dropped 5.6% since, the figures show.

The new data show a 20% difference in level of antibiotic prescribing between the bottom 1% and top 1% areas in England by deprivation.

The map shows that the most antibiotics are prescribed in deprived coastal towns of Lincolnshire, Norfolk, and Essex. Clacton-on-Sea in Essex has antibiotic prescribing rates that are almost twice the national average. In comparison, doctors in the Greater London area are prescribing 21% fewer antibiotics than doctors in the north of England.

Maureen Baker, chair of the Royal College of General Practitioners, said, “These figures show the lowest antibiotic prescribing rates in five years—and a huge drop from when prescribing peaked in 2012. This shows that healthcare professionals across the UK are taking our warnings seriously and working to address them.”

However, she said that the link to deprivation was a concern. “This could quite legitimately be because people in high areas of deprivation present more frequently with conditions such as chronic obstructive pulmonary disease that need antibiotics. It is not necessarily indicative of inappropriate prescribing. There may also be different health expectations regarding the prescription of antibiotics in different areas.”

The prescribing data also show that doctors prescribe 59% more antibiotics in December than they do in August, despite the fact that many illnesses treated by antibiotics are not seasonal.

Colin Garner of Antibiotic Research UK said, “It is true that colds and flus sometimes lead to bacterial infections, due to suppressed immune systems, and so we would expect a minor increase in antibiotic prescription in the winter months. However, the data show us a 59% jump in four months, and this is far too high.

“One explanation is that patients are requesting antibiotics from their GPs for simple coughs and colds, and GPs are acceding to these requests despite the advice they have been given not to prescribe antibiotics for viral conditions such as these.”

Notes

Cite this as: BMJ 2015;351:h6117

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