Trends in antibiotic prescribing in primary care out-of-hours doctors' services in Ireland

Mala Shah; Teresa M Barbosa; Gary Stack; Aoife Fleming

doi:10.1093/jacamr/dlae009

Trends in antibiotic prescribing in primary care out-of-hours doctors' services in Ireland

JAC Antimicrob Resist. 2024 Feb 9;6(1):dlae009. doi: 10.1093/jacamr/dlae009. eCollection 2024 Feb.

Authors

Mala Shah^{1

2}, Teresa M Barbosa², Gary Stack³, Aoife Fleming^{2

4}

Affiliations

¹ Community Operations, Health Service Executive, Cork, Ireland.
² Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland.
³ SouthDoc Out of Hours Doctors Service, Cork and Kerry, Ireland.
⁴ Pharmacy Department, Mercy University Hospital, Grenville Place, Cork, Ireland.

Abstract

Background: Infections are a common reason for patient consultation in out-of-hours (OOH) doctors' services. Surveillance of antibiotic prescribing in OOH settings is important to develop tailored antimicrobial stewardship (AMS) interventions.

Objectives: To evaluate antibiotic prescribing patterns in OOH services in the Cork Kerry region, Ireland to inform future AMS interventions.

Methods: A retrospective, observational cohort study was conducted of all oral antibiotic prescriptions in OOH doctors' consultations between 1 December 2019 and 31 December 2021 in the region. Data were gathered on age, gender, date and time of consultation, consultation method (in person, remote), antibiotic and its indication. Data were analysed using Microsoft Excel v.2018 and SPSS v.28.

Results: Overall, 17% (69 017 of 406 812) of the OOH doctors' consultations resulted in an antibiotic prescription during the study period. This varied from 31% of OOH consultations in December 2019 to less than 2% of OOH consultations in April 2020. Of the antibiotics prescribed, 21% were for children under 6 years old. Respiratory tract infections (RTIs) were the most common indication for antibiotics (59%). Amoxicillin was the most commonly prescribed antibiotic (40% of all prescriptions). Red (reserved) antibiotics accounted for 19% of all prescriptions. During the COVID-19 pandemic period of the study, 66% of 49 421 of antibiotic prescriptions were issued from remote consultations.

Conclusions: Low antibiotic prescribing levels during the early stages of the pandemic were not sustained. Antibiotic prescriptions from remote consultations were common. A key opportunity for AMS is addressing the volume of antibiotic prescribing for RTIs, particularly in children.