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Article: Changes in clinical indications for community antibiotic prescribing for children in the UK from 1996 to 2006: will the new NICE prescribing guidance on upper respiratory tract infections just be ignored?

TitleChanges in clinical indications for community antibiotic prescribing for children in the UK from 1996 to 2006: will the new NICE prescribing guidance on upper respiratory tract infections just be ignored?
Authors
Issue Date2009
PublisherB M J Publishing Group. The Journal's web site is located at http://www.archdischild.com/
Citation
Archives Of Disease In Childhood, 2009, v. 94 n. 5, p. 337-340 How to Cite?
AbstractObjective: To analyse changes in clinical indications for community antibiotic prescribing for children in the UK between 1996 and 2006 and relate these findings to the new NICE guidelines for the treatment of upper respiratory tract infections in children. Study design: Retrospective cohort study. Method: The IMS Health Mediplus database was used to obtain annual antibiotic prescribing rates and associated clinical indications in 0-18-year-old patients between 1 January 1996 and 31 December 2006 in the UK. Results: Antibiotic prescribing declined by 24% between 1996 and 2000 but increased again by 10% during 20032006. Respiratory tract infection was the most common indication for which an antibiotic was prescribed, followed by "abnormal signs and symptoms", ear and skin infections. Antibiotic prescriptions for respiratory tract infections have decreased by 31% (p<0.01) mainly because of reduced prescribing for lower respiratory tract infections (56% decline, p<0.001) and specific upper respiratory tract infections including tonsillitis/pharyngitis (48% decline, p<0.001) and otitis (46% decline, p<0.001). Prescribing for non-specific upper respiratory tract infection increased fourfold (p<0.001). Prescribing for "abnormal signs and symptoms" increased significantly since 2001 (40% increase, p<0.001). Conclusion: There has been a marked decrease in community antibiotic prescribing linked to lower respiratory tract infection, tonsillitis, pharyngitis and otitis. Overall prescribing is now increasing again but is associated with non-specific upper respiratory tract infection diagnoses. General practitioners may be avoiding using diagnoses where formal guidance suggests antibiotic prescribing is not indicated. The new NICE guidance on upper respiratory tract infections is at risk of being ignored.
Persistent Identifierhttp://hdl.handle.net/10722/171380
ISSN
2015 Impact Factor: 3.231
2015 SCImago Journal Rankings: 1.118
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorThompson, PLen_US
dc.contributor.authorSpyridis, Nen_US
dc.contributor.authorSharland, Men_US
dc.contributor.authorGilbert, REen_US
dc.contributor.authorSaxena, Sen_US
dc.contributor.authorLong, PFen_US
dc.contributor.authorJohnson, APen_US
dc.contributor.authorWong, ICKen_US
dc.date.accessioned2012-10-30T06:13:45Z-
dc.date.available2012-10-30T06:13:45Z-
dc.date.issued2009en_US
dc.identifier.citationArchives Of Disease In Childhood, 2009, v. 94 n. 5, p. 337-340en_US
dc.identifier.issn0003-9888en_US
dc.identifier.urihttp://hdl.handle.net/10722/171380-
dc.description.abstractObjective: To analyse changes in clinical indications for community antibiotic prescribing for children in the UK between 1996 and 2006 and relate these findings to the new NICE guidelines for the treatment of upper respiratory tract infections in children. Study design: Retrospective cohort study. Method: The IMS Health Mediplus database was used to obtain annual antibiotic prescribing rates and associated clinical indications in 0-18-year-old patients between 1 January 1996 and 31 December 2006 in the UK. Results: Antibiotic prescribing declined by 24% between 1996 and 2000 but increased again by 10% during 20032006. Respiratory tract infection was the most common indication for which an antibiotic was prescribed, followed by "abnormal signs and symptoms", ear and skin infections. Antibiotic prescriptions for respiratory tract infections have decreased by 31% (p<0.01) mainly because of reduced prescribing for lower respiratory tract infections (56% decline, p<0.001) and specific upper respiratory tract infections including tonsillitis/pharyngitis (48% decline, p<0.001) and otitis (46% decline, p<0.001). Prescribing for non-specific upper respiratory tract infection increased fourfold (p<0.001). Prescribing for "abnormal signs and symptoms" increased significantly since 2001 (40% increase, p<0.001). Conclusion: There has been a marked decrease in community antibiotic prescribing linked to lower respiratory tract infection, tonsillitis, pharyngitis and otitis. Overall prescribing is now increasing again but is associated with non-specific upper respiratory tract infection diagnoses. General practitioners may be avoiding using diagnoses where formal guidance suggests antibiotic prescribing is not indicated. The new NICE guidance on upper respiratory tract infections is at risk of being ignored.en_US
dc.languageengen_US
dc.publisherB M J Publishing Group. The Journal's web site is located at http://www.archdischild.com/en_US
dc.relation.ispartofArchives of Disease in Childhooden_US
dc.subject.meshAdolescenten_US
dc.subject.meshAnti-Bacterial Agents - Administration & Dosageen_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshDrug Administration Scheduleen_US
dc.subject.meshEvidence-Based Medicine - Statistics & Numerical Dataen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshInfanten_US
dc.subject.meshInfant, Newbornen_US
dc.subject.meshMaleen_US
dc.subject.meshOtitis - Drug Therapyen_US
dc.subject.meshPharyngitis - Drug Therapyen_US
dc.subject.meshPhysician's Practice Patterns - Statistics & Numerical Dataen_US
dc.subject.meshPractice Guidelines As Topicen_US
dc.subject.meshRespiratory Tract Infections - Diagnosis - Drug Therapyen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshTonsillitis - Drug Therapyen_US
dc.titleChanges in clinical indications for community antibiotic prescribing for children in the UK from 1996 to 2006: will the new NICE prescribing guidance on upper respiratory tract infections just be ignored?en_US
dc.typeArticleen_US
dc.identifier.emailWong, ICK:wongick@hku.hken_US
dc.identifier.authorityWong, ICK=rp01480en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1136/adc.2008.147579en_US
dc.identifier.pmid19066174-
dc.identifier.scopuseid_2-s2.0-65649145096en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-65649145096&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume94en_US
dc.identifier.issue5en_US
dc.identifier.spage337en_US
dc.identifier.epage340en_US
dc.identifier.isiWOS:000265395000003-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridThompson, PL=25923668200en_US
dc.identifier.scopusauthoridSpyridis, N=22035948400en_US
dc.identifier.scopusauthoridSharland, M=7006566942en_US
dc.identifier.scopusauthoridGilbert, RE=7401932225en_US
dc.identifier.scopusauthoridSaxena, S=12774236400en_US
dc.identifier.scopusauthoridLong, PF=7201512275en_US
dc.identifier.scopusauthoridJohnson, AP=7410016381en_US
dc.identifier.scopusauthoridWong, ICK=7102513915en_US
dc.identifier.citeulike3790774-

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