Abstract
Antimicrobial resistance has become one of the greatest threats to global health. Over 80% of antibiotics are prescribed in primary care, with many prescriptions considered to be issued inappropriately. The aim of this study was to examine the association between prescribing rates and demographic, practice, geographic, and socioeconomic characteristics using a multilevel modelling approach. Antibiotic prescribing data by 320 GP surgeries in Northern Ireland were obtained from Business Services Organisation for the years 2014–2020. A linear mixed-effects model was used to identify factors influencing antibiotic prescribing rates. Overall, the number of antibacterial prescriptions decreased by 26.2%, from 1,564,707 items in 2014 to 1,155,323 items in 2020. Lower levels of antibiotic prescribing were associated with urban practices (p < 0.001) and practices in less deprived areas (p = 0.005). The overall decrease in antibacterial drug prescriptions over time was larger in less deprived areas (p = 0.03). Higher prescribing rates were linked to GP practices located in areas with a higher percentage of the population aged ≥65 (p < 0.001) and <15 years (p < 0.001). There were also significant regional differences in antibiotic prescribing. We advocate that any future antibiotic prescribing targets should account for local factors.
Highlights
Antimicrobial resistance (AMR), identified by the World Health Organisation as one of the top global public health threats, is largely driven by excessive and inappropriate prescribing [1]
The delivery of key components of this five-year national action plan was supported by the establishment of the English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) focusing on enhancing the surveillance of antimicrobial resistance, monitoring antibiotic prescribing, and supporting interventions aimed at improving prescribing process [6]
NHS primary care in Northern Ireland was the setting, including general practices (n = 320) that were operational throughout the study period, with antibiotic prescriptions dispensed from January 2014 to December 2020
Summary
Antimicrobial resistance (AMR), identified by the World Health Organisation as one of the top global public health threats, is largely driven by excessive and inappropriate prescribing [1]. The delivery of key components of this five-year national action plan was supported by the establishment of the English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) focusing on enhancing the surveillance of antimicrobial resistance, monitoring antibiotic prescribing, and supporting interventions aimed at improving prescribing process [6]. These actions resulted in an overall 9% reduction in antibiotic consumption in primary and secondary care over the period 2014–2018 [7].
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