Community-acquired pneumonia mortality: a potential link to antibiotic prescribing trends in general practice

David Brendan Price, D. Honeybourne, P. Little, R. T. Mayon-White, R. C. Read, Michael David Thomas, M. C. Wale, P. FitzGerald, A. R. Weston, Christopher Charles Winchester

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Abstract

Background: Community prescribing of antibiotics has decreased substantially in the UK in recent years. We examine the association between pneumonia mortality and recent changes in community-based antibiotic prescribing for lower respiratory tract infections (LRTI).

Methods: Retrospective analysis of aggregated data for pneumonia mortality, influenza incidence, and antibiotic prescribing for LRTI in England and Wales during 12-week winter periods between 1993/94 and 1999/2000.

Results: Winter antibiotic prescribing for LRTI showed a 30.0% decline since 1995/96. Over the same period, there was a 50.6% increase in winter excess pneumonia mortality adjusted for influenza incidence. Negative binomial regression analysis showed that the incidence of influenza alone had a significant association with winter pneumonia mortality (P<0.001). The analysis also showed the reduction in antibiotic prescribing had a small but significant association with mortality (P<0.001), when simultaneously modelling for influenza incidence.

Original languageEnglish
Pages (from-to)17-24
Number of pages8
JournalRespiratory Medicine
Volume98
Issue number1
DOIs
Publication statusPublished - 1 Jan 2004

Keywords

  • antibiotic prescribing
  • lower respiratory tract infection
  • community-acquired pneumonia mortality
  • retrospective analysis
  • England and Wales
  • influenza epidemics
  • primary-care
  • escherichia-coli
  • resistance
  • children
  • impact
  • rates

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