Antibiotic prescribing

Prescribing of medication is the most common form of treatment. However, inappropriate prescription and overuse of antibiotics results in antibiotic resistance, which may in turn limit our ability to control basic infections. While we cannot establish the exact antibiotic prescribing rate, trends should be closely monitored.

Twenty most prescribed drugs in the community in England in 2013

The graph shows the 20 drugs with greatest number of items dispensed in 2013. Penicillins are the most prescribed form of antibiotics. Amoxicillin, one of the most widely used broad-based penicillins, is amongst the most prescribed drugs with 13.2 millions items dispensed in 2013; and is the only antibiotic which features in the twenty most prescribed drugs in 2013.

Source: 
Health and Social Care Information Centre, Prescriptions Dispensed in the Community

How has penicillin prescribing changed over time?

The number of broad-spectrum penicillins dispensed (including amoxicillin) has been gradually increasing from 15.3 million items in 2003 to 16.7 million items in 2012. In 2013, we observed a decline to 15.4 million items. The use of penicillinase-resistant penicillins has also been increasing over time, from 3.2 million items in 2003 to 4.3 million in 2013.

Source: 

Health and Social Care Information Centre, Prescriptions Dispensed in the Community

What other antibiotics are most prescribed?

This graph shows the use of other antibacterial groups (excluding penicillins and groups with less than 100,000 items dispensed in 2013) and we see an increase in use for most types. The exception is cephalosporins where the use has suddenly declined since 2007. This sudden decline is likely to be linked with the numerous initiatives aiming to reduce the use of cephalosporins as an effective control measure for the incidence of clostridium difficile infection among hospital patients.

Source: 

Health and Social Care Information Centre, Prescriptions Dispensed in the Community

How does antibiotic prescribing compare internationally?

The OECD collects data on prescribing in different countries using a system of average Defined Daily Doses to account for the volume of drugs. Since 2000 the volume of antibiotics prescribed in the UK has increased from 14.3 Defined Daily Dosage (DDD) per day per 1000 inhabitants to 19.4 in 2012. The UK prescribes fewer antibiotics than many other countries, but the increasing trend is worrying. Lowest antibiotic prescribing can be observed in the Netherlands, Germany and Sweden, with Sweden managing to be on a continuous decline since 2007.

Last updated: July 2015. 

Source: 

OECD, Health Statistics 2014

Cephalosporins and quinolones as a proportion of all antibiotics prescribed

As mentioned above, two drugs of particular importance are cephalosporins and quinolones as these are second-line antibiotics restricted for situations where first-line antibiotics have failed (OECD, 2013c). Reflecting the trend in England above, this figure shows that their prescribing in the UK as a proportion of all antibiotics prescribed has been on a sharp decline since 2007 and that the UK performs the best out of all the comparator countries. 

Last updated: July 2015. 

Source: 

European Centre for Disease Prevention and Control

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