Do general practitioners prescribe more antimicrobials when the weekend comes?

Meera Tandan, Sinead Duane, Akke Vellinga, Meera Tandan, Sinead Duane, Akke Vellinga

Abstract

Inappropriate antimicrobial prescribing contributes to the global spread of antimicrobial resistance. The pending weekend with changed availability of general practitioners (GP) and increased patient concern may increase the intention to prescribe antimicrobials. The aim of this study is to analyse variation in antimicrobial prescribing between weekdays and weekend in Irish general practice. All prescribing data over a 15 month period was obtained from the 30 practices participating in the Supporting the Improvement and Management of Prescribing for urinary tract infection (SIMPle) study. Antimicrobials were classified using anatomical therapeutic chemical classification code guidelines. Prescribing of antimicrobials per total number of prescriptions was compared between weekdays (Monday to Thursday) and the weekend (Friday to Sunday). Antimicrobials were generally more often prescribed during weekends; the antimicrobial prescribing rate was greater by 9.2 % on Friday compared to average prescribing on other weekdays (21.4 vs. 19.6 %). The chance of an antimicrobial prescription was 1.07 (95 % CI 1.04-1.10) higher on weekend days compared to weekdays. This was reflected in increased prescriptions for ampicillin, co-amoxiclav, nitrofurantoin, quinolones and macrolides. However, if antimicrobials were prescribed, no significant differences were observed between weekdays and weekend among the different classes of antimicrobials. GPs prescribe relatively more antimicrobials during the weekend compared to weekdays. However, the patterns of antimicrobial prescribing did not differ according to the day of prescription. Trial Registration The intervention was registered with ClinicalTrials.gov on 26 July 2013, ID number NCT01913860.

Keywords: Antimicrobial prescribing; General practice; Weekend.

Figures

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Fig. 1
Antimicrobials prescribing based on the total prescription made on the different weekdays

References

    1. Blommaert A, et al. Determinants of between-country differences in ambulatory antibiotic use and antibiotic resistance in Europe: a longitudinal observational study. J Antimicrob Chemother. 2014;69(2):535–547. doi: 10.1093/jac/dkt377.
    1. Bronzwaer SL, et al. A European study on the relationship between antimicrobial use and antimicrobial resistance. Emerg Infect Dis. 2002;8(3):278–282. doi: 10.3201/eid0803.010192.
    1. Cotter M, Daly L. Antibiotic prescription practices of general practitioners. Ir Med J. 2007;100(9):598–601.
    1. Duane S, et al. Supporting the improvement and management of prescribing for urinary tract infections (SIMPle): protocol for a cluster randomized trial. Trials. 2013;14:441. doi: 10.1186/1745-6215-14-441.
    1. Health Insurance Authority (2014) Health Insurance Authority Consumers Survey
    1. Huibers L, et al. Antibiotic prescribing patterns in out-of-hours primary care: a population-based descriptive study. Scand J Prim Health Care. 2014;32(4):200–207. doi: 10.3109/02813432.2014.972067.
    1. Hulscher ME, van der Meer JW, Grol RP. Antibiotic use: how to improve it? Int J Med Microbiol. 2010;300(6):351–356. doi: 10.1016/j.ijmm.2010.04.003.
    1. Kuehlein T, et al. Antibiotic prescribing in general practice—the rhythm of the week: a cross-sectional study. J Antimicrob Chemother. 2010;65(12):2666–2668. doi: 10.1093/jac/dkq364.
    1. Little P, et al. Delayed antibiotic prescribing strategies for respiratory tract infections in primary care: pragmatic, factorial, randomised controlled trial. BMJ. 2014;348:g1606. doi: 10.1136/bmj.g1606.
    1. Lynch J (2004) Lights out of the surgery—where to next? In: Open forum. ICGP (Online)
    1. Murphy M, Byrne S, Bradley CP. Influence of patient payment on antibiotic prescribing in Irish general practice: a cohort study. Br J Gen Pract. 2011;61(590):e549–e555. doi: 10.3399/bjgp11X593820.
    1. WHO (2014a) Antimicrobial Resistance Global Report on Surveillance
    1. WHO . Guidelines for ATC classification and DDD assignment 2015. Oslo: WHO Collaborating Centre for Drug Statistics Methodology; 2014.

Source: PubMed

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