Respiratory antibacterial prescribing in primary care and the COVID-19 pandemic in England, winter season 2020-21

J Antimicrob Chemother. 2022 Feb 23;77(3):799-802. doi: 10.1093/jac/dkab443.

Abstract

Background: Antibacterial prescribing for respiratory tract infections (RTIs) accounts for almost half of all prescribing in primary care. Nearly a quarter of antibacterial prescribing in primary care is estimated to be inappropriate, the greatest being for RTIs. The COVID-19 pandemic has changed the provision of healthcare services and impacted the levels of antibacterials prescribed.

Objectives: To describe the changes in community antibacterial prescribing for RTIs in winter 2020-21 in England.

Methods: RTI antibacterial prescribing was measured in prescription items/1000 population for primary care from January 2014 and in DDDs/1000 population/day for the totality of RTI prescribing [combined with Accident & Emergency (A&E) in secondary care], from January 2016 to February 2021. Trends were assessed using negative binomial regression and seasonally adjusted interrupted time-series analysis.

Results: Antibacterials prescribed for RTIs reduced by a further 12.4% per season compared with pre-COVID (P < 0.001). In winter 2020-21, RTI prescriptions almost halved compared with the previous winter in 2019-20 (P < 0.001). The trend observed for total RTI prescribing (primary care with A&E) was similar to that observed in the community alone.

Conclusions: During COVID-19, RTI prescribing reduced in the community and the expected rise in winter was not seen in 2020-21. We found no evidence that RTI prescribing shifted from primary care to A&E in secondary care. The most likely explanation is a decrease in RTIs and presentations to primary care associated with national prevention measures for COVID-19.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • COVID-19*
  • England / epidemiology
  • Humans
  • Inappropriate Prescribing / prevention & control
  • Pandemics
  • Practice Patterns, Physicians'
  • Primary Health Care
  • Respiratory Tract Infections* / drug therapy
  • Respiratory Tract Infections* / epidemiology
  • SARS-CoV-2
  • Seasons

Substances

  • Anti-Bacterial Agents