Antibiotic prescribing frequency amongst patients in primary care: a cohort study using electronic health records

Shallcross, Laura; Beckley, Nick; Rait, Greta; Hayward, Andrew; Petersen, Irene

doi:10.1093/jac/dkx048

Cited by 71 publications

(68 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…20 In the United Kingdom, 30% of patients are prescribed at least one antibiotic annually. 21 Our findings support the hypothesis that antibiotics may be contributing to the increasing prevalence and earlier age at onset of nephrolithiasis. 22 Given that children receive more antibiotics than any other age group, and 30% of antibiotics prescribed during ambulatory care visits are inappropriate, 23-25 these findings provide another reason to reduce inappropriate outpatient antibiotic use.…”

Section: Discussionsupporting

confidence: 86%

Oral Antibiotic Exposure and Kidney Stone Disease

Tasian¹,

Jemielita

Goldfarb

et al. 2018

JASN

113

View full text Add to dashboard Cite

Although intestinal and urinary microbiome perturbations are associated with nephrolithiasis, whether antibiotics are a risk factor for this condition remains unknown. We determined the association between 12 classes of oral antibiotics and nephrolithiasis in a population-based, case-control study nested within 641 general practices providing electronic health record data for >13 million children and adults from 1994 to 2015 in the United Kingdom. We used incidence density sampling to match 25,981 patients with nephrolithiasis to 259,797 controls by age, sex, and practice at date of diagnosis (index date). Conditional logistic regression models were adjusted for the rate of health care encounters, comorbidities, urinary tract infections, and use of thiazide and loop diuretics, proton-pump inhibitors, and statins. Exposure to any of five different antibiotic classes 3-12 months before index date was associated with nephrolithiasis. The adjusted odds ratio (95% confidence interval) was 2.33 (2.19 to 2.48) for sulfas, 1.88 (1.75 to 2.01) for cephalosporins, 1.67 (1.54 to 1.81) for fluoroquinolones, 1.70 (1.55 to 1.88) for nitrofurantoin/methenamine, and 1.27 (1.18 to 1.36) for broad-spectrum penicillins. In exploratory analyses, the magnitude of associations was greatest for exposure at younger ages (<0.001) and 3-6 months before index date (<0.001), with all but broad-spectrum penicillins remaining statistically significant 3-5 years from exposure. Oral antibiotics associated with increased odds of nephrolithiasis, with the greatest odds for recent exposure and exposure at younger age. These results have implications for disease pathogenesis and the rising incidence of nephrolithiasis, particularly among children.

show abstract

Section: Discussionsupporting

confidence: 86%

Oral Antibiotic Exposure and Kidney Stone Disease

Tasian¹,

Jemielita

Goldfarb

et al. 2018

JASN

113

View full text Add to dashboard Cite

show abstract

“…The differences could be because of different patient populations. [15][16][17] The analysis of indications for the admissions in MICU in this study showed that the most common disease for which patients were admitted in intensive care units included organophosphorus poisoning (24.86%), snake bite (15.14%), bilateral pneumonitis (12.71%), HELLP syndrome (12.14%), respectively and the least common pathologies included COPD with respiratory failure (10.43%), meningitis (6.14%), sepsis with MODS (4.71%), GBS (3.86%), lung abscess (3.0%), alcoholic liver disease (1.57%), chronic kidney disease (1.43%), encephalitis (1.14%), infective endocarditis (1.57%) and stroke (1.29%). In contrast, the most common indications for admission in MICU in study conducted by Crucio D was nosocomial pneumonia (21%), community pneumonia (14%), intra-abdominal infections (12%), genitourinary infections (12%), CNS infections (6.7%), skin infection (6.7%), sepsis (6.7%), etc.…”

Section: Discussionmentioning

confidence: 99%

To study the prescription pattern of antibiotics in medicine intensive care unit at tertiary care hospital

Naikwadi

Baig

Bhattacharya

2019

Int J Basic Clin Pharmacol

View full text Add to dashboard Cite

Background: Drug utilization studies are crucial and create a positive awareness about proper use of drugs. Analysing the pattern of prescriptions is important in the settings of intensive care units where patients receive multiple antibiotics. The objective of this study was to analyse the use of antibiotics in a Medicine Intensive Care Unit (MICU) of Government Medical College and Hospital, Aurangabad, Maharashtra, India, a tertiary health care centre.Methods: Total 988 number of patients admitted in MICU from January 2017 to June 2018 were enrolled in the study and fulfilling inclusion criteria. Demographic details, disease state and prescription of antibiotic was recorded.Results: Out of 988, n=700 patients received antibiotics. Most common diseases for which patients were admitted in MICU included OP poisoning (24.86%), snake bite (15.14%), bilateral pneumonitis (12.71%), HELLP syndrome (12.14%), and the least common conditions were chronic obstructive pulmonary disease (COPD), meningitis, sepsis with multiple organ dysfunction syndrome (MODS), Guillen barre syndrome (GBS), lung abscess etc., Most common single antibiotic used in the studied cases was ceftriaxone (21.42%) followed by either alone or in combination piperacillin and tazobactam (12.04%), metronidazole (11.85%) etc.Conclusions: Total 700 patients received systemic antibiotics in present study bringing the incidence of systemic antibiotics use in MICU to be 70.85%. Ceftriaxone and combination of piperacillin and tazobactam are most commonly used antibiotics in MICU of the hospital. All patients admitted in this MICU received antibiotics as per the standard protocols of the hospital.

show abstract

“…11 Thirty percent of patients are prescribed at least 1 antibiotic annually. 12 In this issue of AJKD, Ferraro et al 13 reported that prior antibiotic exposure is associated with incident symptomatic kidney stones among women in the well-characterized Nurses' Health Study (NHS) I and II cohorts. Strengths of the study include prospectively collected antibiotic exposures and, for a subset of participants, availability of 24-hour urine chemistry test results.…”

mentioning

confidence: 99%