What has happened to antimicrobial usage in primary care in the United Kingdom since the SMAC report? - description of trends in antimicrobial usage using the General Practice Research Database.
BACKGROUND
The aim of the study was to assess antibiotic prescribing within the United Kingdom for three of the Standing Medical Advisory Committee recommendations 'four things which could be done'.


METHODS
We conducted a retrospective survey of morbidity and antibiotic prescribing data between 1993 and 2001 using the national General Practice Research Database. Antibiotic prescribing was linked to diagnoses of cough/cold and sore throat; length of antibiotic course for uncomplicated cystitis.


RESULTS
The rate of antibiotic prescribing for cough/cold declined between 1993 (43.7 per 1000 patient years at risk) and 1999 (23.5 per 1000 patient years at risk) and has since increased slightly (to 30.5 per 1000 patient years at risk in 2001). Antibiotic prescribing for sore throat declined between 1995 (80.6 per 1000 patient years at risk) and 1999 and has since remained static (42.1 per 1000 patient years at risk in 2001). Trimethoprim was the most commonly used antibiotic for episodes of uncomplicated cystitis and the prescription of 3 day (or less) courses has increased from 16.4 per cent in 1998 to 41.5 per cent in 2001.


CONCLUSIONS
For the SMAC recommendation to limit prescribing for uncomplicated cystitis to 3 days in otherwise fit women there has been demonstrable impact since the publication of the SMAC report. For two recommendations (no prescribing of antibiotics for simple coughs and colds; no prescribing of antibiotics for viral sore throats) the impact has been less clear against the background of a general reduction in antimicrobial prescribing.
Smith
Gillian E
GE
Regional Surveillance Unit, Health Protection Agency West Midlands, 2nd Floor, Lincoln House, Birmingham Heartlands Hospital, Bordesley Green East, Bordesley Green, Birmingham B9 5SS. gillian.smith@hpa.org.uk
Smith
Sue
S
Heatlie
Heath
H
Bashford
James N R
JN
Hawker
Jeremy
J
Ashcroft
Darren
D
Millson
David
D
Verlander
Neville Q
NQ
Warren
Roderic
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D019992:Databases as Topic; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends*; D005194:Family Practice / Q000592:standards* / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D009017:Morbidity; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D040442:Public Health Informatics; D012189:Retrospective Studies; D006113:United Kingdom
D000900:Anti-Bacterial Agents