Age-related changes in consultations and antibiotic prescribing for acute respiratory infections, 1995-2000. Data from the UK General Practice Research Database.
BACKGROUND
International studies using data aggregated for all ages have shown decreasing rates of general practice consultations for acute respiratory infections with fewer antibiotic prescriptions issued per consultation. The occurrence of different respiratory infections varies widely at different ages but we do not know whether prescribing has reduced equally in all age groups.


OBJECTIVE
We aimed to determine how reductions in consultation rates and antibiotic prescribing varied with age for different respiratory infections.


METHODS
Data were abstracted from the General Practice Research Database for 108 general practices in the UK (mean registered population 642 685). We estimated age-specific changes between 1995 and 2000 in consultation rates, and the proportion of consultations resulting in an antibiotic prescription for 'all respiratory infections' and for 'sore throat', 'ear infection', 'bronchitis' and 'chest infection'.


RESULTS
Consultation rates for 'all respiratory infections' declined in all age groups with the greatest decreases in children aged 1-4 years (41%), 5-10 year olds (53%) and 11-16 year olds (54%), whereas at 75-84 years the reduction was 28%. The pattern of greater reductions in children held for each separate condition even though the age of peak incidence varied. The relative reduction in antibiotic prescribing was greatest at 1-4 years (18%), 5-10 years (17%) and 11-16 years (17%), compared with 5% at 75-84 years. Antibiotic prescribing decreased most for sore throat and this was observed at all ages particularly in 5-10 year olds (relative reduction, 32%).


CONCLUSIONS
School age children account for the greatest reduction in consultations for acute respiratory infection. School age and preschool children account for the greatest reductions in antibiotic prescribing during the consultation. The rapid changes in consultation rates are unexplained.
Ashworth
M
M
Department of General Practice & Primary Care, King's College London School of Medicine at Guy's, King's College and St Thomas' Hospitals, London, UK. mark.ashworth@gp-G85053.nhs.uk
Charlton
J
J
Latinovic
R
R
Gulliford
M
M
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D016208:Databases, Factual; D005194:Family Practice; D006801:Humans; D007223:Infant; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D006113:United Kingdom
D000900:Anti-Bacterial Agents