Antibiotic prescribing and admissions with major suppurative complications of XXXX : a data linkage study.

@entity1 @entity114 @entity5047 @entity1729 @entity2267
BACKGROUND: Systematic reviews of antibiotic treatment of common acute @entity1729 ( @entity1729 ) suggest modest symptomatic benefit, but provide limited evidence that prescribing prevents complications. AIM: To assess the relationship between @entity114 prescribing (the most commonly used group of antibiotics for @entity1729 ) and hospital admission with complications. DESIGN OF STUDY: Data linkage study. SETTING: Ninety-six health authorities of England for the year 1997-1998. METHOD: Hospital admissions related to @entity1729 were linked with prescribing analysis and cost (PACT) data. RESULTS: There was close correlation between items of @entity114 use and total antibiotic use (r = 0.96). After controlling for @entity5047 , age, sex, and Townsend score, a one-unit increase in @entity114 use (items dispensed per capita) was associated with a reduction in annual incidence per 10,000 of admissions for quinsy (-3.55 admissions, 95% confidence interval [CI] = -6.85 to -0.26), and @entity2267 (square root of incidence of admissions = -1.05, 95% CI = -1.82 to -0.27). This does not represent lower referral thresholds among higher prescribers as higher prescribing was associated with more admissions for tonsillectomy and overall admissions. Increasing prescribing by 2000 items of @entity114 for a practice of 10,000 @entity1 could possibly prevent one admission for either @entity2267 or quinsy. CONCLUSION: Higher antibiotic prescribing is associated with significantly fewer admissions with major complications. However, the overall size of the effect is modest and it is difficult to advocate an overall increase in prescribing to prevent complications. Future research should concentrate on finding better methods of targeting antibiotics to individuals at risk of poor outcome.
