Britain could face 'post-antibiotic apocalypse'
You may have seen the recent article in the papers (https://www.telegraph.co.uk/news/2017/10/13/britain-could-face-post-antibiotic-apocalypse-warns-top-doctor/), or heard the interviews on the Radio, too much use of antibiotics means we could all be doomed! A post-antibiotics apocalypse as Prof Dame Sally Davies says. Now I am no expert on apocalypses but they do not sound very nice so I am sure we are all keen to do all we can to avoid one right?
Therefore, I thought I would look at the NHS primary care prescribing data for England and see what has happened to prescribing over the past six or so years. I decided to use Items for my analysis to avoid any bias that price fluctuations would cause. My analysis has been done against the BNF chapter 5.1.
Firstly, I looked at the number of items per month:-
The most interesting insight I took from this chart was although the overall trend appears relatively flat there does appear to be a drop in the prescribing in the peak winter months. Looking at the data annually does show the overall trend better:-
As you can see when we look at the data year on year, it is quite clear that prescribing is decreasing which is good news for all of us. It is worth noting the default y-axis that excel chose certainly helps 'enhance' this decrease. Analysing these data further the fall seems to be spread out across all classes of antibiotics except for 05:01:03:0 Tetracyclines & 05:01:13:0 Urinary-Tract Infections which still appear to be increasing as shown here:-
When you look at National trends sometimes this can mask the underlying issues. For this reason I decided to drill to practice level to see how each practice is doing. What I found was quite interesting, roughly speaking as many practices have increased their prescribing as have decreased it. Further investigation is probably required as to why (Looking at prescribing rates, Population changes, etc.).
Conclusion
Prescribing does appear to be moving in the right direction. GP's are clearly aware of this danger and many of them are acting now. I Hope this trend continues and the four horsemen of the apocalypse will not be riding into your, or my town anytime soon. Thank you for taking the time to read this article.
Source: Data (primary care prescribing data) is provided by NHS Digital and published under the open government licence.
To get on the news you need apocalyptic headlines but reality is usually more nuanced. There was a recent BBC documentary that looked at over prescrbing: https://www.bbc.co.uk/programmes/b07w532p Despite Dr Chris van Tulleken's best efforts to avoid prescribing antibiotics in a typical GP's consultation he couldnt reduce it as much as he thought. Perhaps the prescribing trends are showing that the over prescribing message is getting through but that there is a base-line that just cant go away