title: An association between socioeconomic deprivation and primary care antibiotic prescribing in Scotland.
abstract: OBJECTIVE
  To evaluate the association between socioeconomic deprivation and antibiotic prescribing in Scotland.
  
  
  METHODS
  Data for dispensed antibiotic prescriptions written by general practitioners were obtained for all Scottish National Health Service boards from 2010 to 2012. Deprivation was assessed linking dispensing events to the Scottish Index of Multiple Deprivation (SIMD) score for the patient's datazone (neighbourhood area). The relationship between the deprivation area and antibiotic use (items per 1000 persons per day) was stratified according to the patient's age and sex and the antibiotic class dispensed. A multivariate Poisson regression model was used to formally test the associations.
  
  
  RESULTS
  Approximately 12 million prescription items during 2010-2012 were assessed. Patients in the most deprived SIMD quintile had an overall prescription rate that was 36.5% higher than those in the least deprived quintile. The effect of deprivation upon prescription rates was most pronounced for women aged 40-59 years, and for penicillins and metronidazole.
  
  
  CONCLUSIONS
  Deprivation was found to have a consistent association with increased rates of antibiotic prescribing in Scotland, which may have significant implications for antimicrobial stewardship and public health campaigns.
authors.affiliation: Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK.
authors.forename: Jordan R
authors.initials: JR
authors.lastname: Covvey
authors.forename: Blair F
authors.initials: BF
authors.lastname: Johnson
authors.forename: Victoria
authors.initials: V
authors.lastname: Elliott
authors.forename: William
authors.initials: W
authors.lastname: Malcolm
authors.forename: Alexander B
authors.initials: AB
authors.lastname: Mullen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D055553:Prescription Drugs / Q000627:therapeutic use*; D055656:Prescriptions / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods*; D012606:Scotland; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D055553:Prescription Drugs
keywords: Antimicrobial stewardship; database; public health