Abstract
BackgroundAntibiotic overuse is linked to increased risk of antimicrobial resistance. Long-term antibiotics are commonly used for treating acne and prophylaxis of urinary tract infection. Their contribution to the overall burden of antibiotic use is relatively unknown.AimTo describe the volume of commonly prescribed long-term (≥28 days) antibiotic prescriptions in adolescents and young adults, trends over time, and comparisons with acute prescriptions.Design and settingA retrospective cohort study using UK electronic primary care records.MethodPatients born between 1979 and 1996 and with data in the Care and Health Information Analytics database were included. The main outcome measures were antibiotic prescription rates per 1000 person-years and antibiotic prescription days per person-year between the ages of 11 and 21.ResultsIn total, 320 722 participants received 710 803 antibiotic prescriptions between the ages of 11 and 21 years from 1998 to 2017. Of these 710 803 prescriptions, 191 443 (26.93%) were for long-term antibiotics (≥28 days and ≤6 months in duration). Long-term antibiotics accounted for more than two-thirds (72.48%) of total antibiotic exposure (days per person-year). Total long-term antibiotic prescribing peaked in 2013 at just under 6 days per person-year and declined to around 4 days in 2017.ConclusionAmong adolescents and young adults, exposure to long-term antibiotics (primarily lymecycline used for acne) was much greater than for acute antibiotics and is likely to make an important contribution to antimicrobial resistance. Urgent action is needed to reduce unnecessary exposure to long-term antibiotics in this group. Increasing the use of, and adherence to, effective non-antibiotic treatments for acne is key to achieving this.
Highlights
IntroductionA growing number of common infections are becoming harder to treat because of Antimicrobial resistance (AMR), which can lead to longer hospital stays, higher medical costs, and increased mortality.[1] Unnecessary and inappropriate use of antibiotics promotes the emergence and spread of resistant bacteria.[2] This effect increases the population-level carriage of organisms resistant to first-line antibiotics, but can increase the use of second-line antibiotics in the community.[3]
Antimicrobial resistance (AMR) is a major threat to global health as new resistance mechanisms emerge and spread globally.[1]A growing number of common infections are becoming harder to treat because of AMR, which can lead to longer hospital stays, higher medical costs, and increased mortality.[1]
Among adolescents and young adults, exposure to long-term antibiotics was much greater than for acute antibiotics and is likely to make an important contribution to antimicrobial resistance
Summary
A growing number of common infections are becoming harder to treat because of AMR, which can lead to longer hospital stays, higher medical costs, and increased mortality.[1] Unnecessary and inappropriate use of antibiotics promotes the emergence and spread of resistant bacteria.[2] This effect increases the population-level carriage of organisms resistant to first-line antibiotics, but can increase the use of second-line antibiotics in the community.[3]. Long-term antibiotics are commonly used for treating acne and prophylaxis of urinary tract infection. Their contribution to the overall burden of antibiotic use is relatively unknown
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