Impact of the COVID-19 Pandemic on the Prescribing Patterns of First-Line Antibiotics in English Primary Care: A Longitudinal Analysis of National Prescribing Dataset
Abstract
:1. Introduction
2. Results
2.1. Prescribing of First-Line Antibiotics between 2018 and 2020
2.2. Prescribing Patterns of First-Line Antibiotics by Pharmacological Drug Classification and Anatomical Infection Sites
2.3. Costs Associated with Prescribing of First-Line Antibiotics between 2018 and 2020
3. Discussion
Strengths and Limitations
4. Materials and Methods
4.1. Study Design and Population
4.2. Data Extraction and Analysis
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Antibiotic | Items Prescribed (March–September) | % Difference 2020 and 2018 (p-Value) * | % Difference 2020 and 2019 (p-Value) * | ||
---|---|---|---|---|---|
2018 | 2019 | 2020 | |||
Amoxicillin | 3,788,146 | 3,656,355 | 2,548,155 | −32.7 (0.035) | −43.5 (0.035) |
Phenoxymethylpenicillin | 1,345,567 | 1,224,614 | 938,718 | −30.2 (0.048) | −23.35 (0.025) |
Doxycycline | 1,418,699 | 1,552,700 | 1,512,059 | 6.6 (0.949) | −2.6 (0.225) |
Clarithromycin | 1,150,884 | 1,114,988 | 914,060 | −20.6 (0.048) | −18.0 (0.064) |
Co-amoxiclav | 781,027 | 733,962 | 730,055 | −6.5 (0.085) | −1.0 (0.565) |
Nitrofurantoin | 2,296,145 | 2,436,156 | 2,418,624 | 5.3 (0.048) | −0.7 (0.749) |
Trimethoprim | 1,131,986 | 952,513 | 892,998 | −21.1 (0.002) | −6.3 (0.009) |
Ciprofloxacin | 333,774 | 280,746 | 258,309 | −22.6 (0.002) | −7.9 (0.013) |
Ofloxacin | 20,222 | 19,525 | 23,413 | 15.8 (0.004) | 19.9 (0.002) |
Cefalexin | 428,462 | 422,528 | 445,779 | 4.0 (0.0085) | 5.5 (0.025) |
Benzylpenicillin | 373 | 297 | 112 | −69.9 (0.002) | −62.3 (0.002) |
Metronidazole (Oral) | 337,999 | 331,865 | 304,898 | −9.8 (0.002) | −8.1 (0.002) |
Vancomycin | 2710 | 2417 | 3152 | 16.3 (0.018) | 30.4 (0.013) |
Metronidazole (Topical) | 17,028 | 19,821 | 21,406 | 25.7 (0.002) | 8.0 (0.064) |
Clindamycin (Topical) | 18,676 | 17,213 | 15,139 | −18.9 (0.002) | −12.1 (0.002) |
Fusidic acid | 637,990 | 627,026 | 473,193 | −25.8 (0.002) | −24.5 (0.002) |
Mupirocin | 38,692 | 38,398 | 31,038 | −19.8 (0.003) | −19.8 (0.002) |
Flucloxacillin | 2,502,571 | 2,388,848 | 2,256,687 | −9.8 (0.110) | −5.5 (0.655) |
Ceftriaxone | 828 | 616 | 570 | −31.2 (0.005) | −7.5 (0.749) |
Chloramphenicol | 735,945 | 683,392 | 482,716 | −34.4 (0.004) | −29.4 (0.002) |
All antibiotics | 16,987,724 | 16,503,980 | 14,271,081 | −15.99 (0.018) | −13.5 (0.002) |
Number of Items Prescribed between March and September in Millions * | % Difference 2020–2018 (p-Value) * | % Difference 2020–2019 (p-Value) * | |||
---|---|---|---|---|---|
2018 | 2019 | 2020 | |||
Upper respiratory tract | 5.13 | 4.88 | 2.97 | −42.13 (0.025) | −39.13 (0.035) |
Lower respiratory tract | 7.13 | 7.05 | 4.90 | −31.40 (0.064) | −30.62 (0.085) |
Urinary tract infection | 4.99 | 4.84 | 4.07 | −18.52 (0.002) | −16.06 (0.002) |
Meningitis | 0.0004 | 0.0003 | 0.00009 | −69.9 (0.002) | −62.3 (0.002) |
Gastro-intestinal tract | 6.07 | 5.84 | 3.85 | −36.42 (0.035) | −34.01 (0.048) |
Genital tract | 2.14 | 2.22 | 1.84 | −14.33 (0.482) | −17.23 (0.18) |
Skin and soft tissue | 10.67 | 10.44 | 7.50 | −29.59 (0.025) | −28.17 (0.035) |
Eye infection | 0.74 | 0.69 | 0.42 | −42.63 (0.004) | −38.22 (0.002) |
Dental infection | 5.47 | 5.21 | 3.23 | −40.95 (0.025) | −38.02 (0.035) |
Number of Items Prescribed in Millions | % Difference 2018–2020 (p-Value)* | % Difference 2019–2020 (p-Value) * | |||
---|---|---|---|---|---|
2018 | 2019 | 2020 | |||
Penicillin | 8.41 | 8.00 | 6.47 | −23.09 (0.018) | −19.12 (0.025) |
Cephalosporins | 0.43 | 0.42 | 0.45 | 3.98 (0.085) | 5.49 (0.025) |
Macrolides | 1.15 | 1.11 | 0.91 | −20.58 (0.048) | −18.02 (0.064) |
Quinolones | 0.35 | 0.30 | 0.28 | −20.42 (0.002) | −6.18 (0.0035) |
Tetracyclines | 1.42 | 1.55 | 1.51 | 6.58 (0.949) | −2.62 (0.225) |
Others | 5.41 | 5.30 | 4.80 | −11.19 (0.002) | −9.43 (0.002) |
Antibiotic | Costs in Millions | % Difference 2020–2018 (p-Value) * | % Difference2020–2019 (p-Value) * | ||
---|---|---|---|---|---|
2018 | 2019 | 2020 | |||
Amoxicillin | 4.12 | 4.49 | 4.26 | 3.18 (0.482) | −5.22 (0.277) |
Phenoxymethylpenicillin | 7.46 | 5.43 | 3.86 | −48.21 (0.006) | −28.90 (0.018) |
Co-amoxiclav | 1.82 | 1.87 | 2.04 | 11.90 (0.013) | 9.03 (0.064) |
Benzylpenicillin | 0.004 | 0.002 | 0.002 | −57.59 (0.025) | −17.33 (0.085) |
Flucloxacillin | 11.24 | 11.29 | 8.13 | −27.70 (0.002) | −28.05 (0.002) |
Cefalexin | 0.73 | 0.78 | 1.06 | 45.78 (0.002) | 36.27 (0.002) |
Ceftriaxone | 0.08 | 0.06 | 0.05 | −36.85 (0.006) | −15.70 (0.085) |
Ciprofloxacin | 0.90 | 0.84 | 0.86 | −4.90 (0.482) | 2.50 (0.620) |
Ofloxacin | 0.78 | 0.72 | 0.87 | 12.58 (0.004) | 20.61 (0.003) |
Doxycycline | 1.75 | 2.38 | 4.16 | 137.37 (0.002) | 74.61 (0.002) |
Clarithromycin | 2.81 | 2.81 | 3.00 | 6.54 (0.482) | 6.74 (0.277) |
Clindamycin | 1.12 | 0.82 | 0.87 | −22.06 (0.002) | 6.45 (0.003) |
Nitrofurantoin | 20.91 | 20.96 | 20.81 | −0.489 (0.949) | −0.75 (0.902) |
Trimethoprim | 1.59 | 1.78 | 1.82 | 14.62 (0.064) | 2.70 (1.000) |
Metronidazole oral | 1.68 | 2.08 | 4.25 | −5.74 (0.655) | −23.87 (0.001) |
Metronidazole ointment | 2.11 | 2.19 | 3.86 | −16.86 (0.655) | −19.98 (0.001) |
Vancomycin | 0.57 | 0.50 | 2.04 | −13.64 (0.225) | −1.48 (0.710) |
Fusidic acid | 1.33 | 1.62 | 0.002 | 33.24 (0.002) | 8.93 (0.142) |
Mupirocin | 0.24 | 0.23 | 8.12 | −18.78 (0.003) | −18.20 (0.002) |
Chloramphenicol | 1.24 | 1.79 | 1.07 | 52.88 (0.003) | 6.19 (0.001) |
All antibiotics | 62.08 | 62.58 | 59.34 | −4.42% (0.180) | −5.18 (0.097) |
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Hussain, A.Z.; Paudyal, V.; Hadi, M.A. Impact of the COVID-19 Pandemic on the Prescribing Patterns of First-Line Antibiotics in English Primary Care: A Longitudinal Analysis of National Prescribing Dataset. Antibiotics 2021, 10, 591. https://doi.org/10.3390/antibiotics10050591
Hussain AZ, Paudyal V, Hadi MA. Impact of the COVID-19 Pandemic on the Prescribing Patterns of First-Line Antibiotics in English Primary Care: A Longitudinal Analysis of National Prescribing Dataset. Antibiotics. 2021; 10(5):591. https://doi.org/10.3390/antibiotics10050591
Chicago/Turabian StyleHussain, Alisha Zubair, Vibhu Paudyal, and Muhammad Abdul Hadi. 2021. "Impact of the COVID-19 Pandemic on the Prescribing Patterns of First-Line Antibiotics in English Primary Care: A Longitudinal Analysis of National Prescribing Dataset" Antibiotics 10, no. 5: 591. https://doi.org/10.3390/antibiotics10050591
APA StyleHussain, A. Z., Paudyal, V., & Hadi, M. A. (2021). Impact of the COVID-19 Pandemic on the Prescribing Patterns of First-Line Antibiotics in English Primary Care: A Longitudinal Analysis of National Prescribing Dataset. Antibiotics, 10(5), 591. https://doi.org/10.3390/antibiotics10050591