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Antibiotic prescribing for chronic skin wounds in primary care

Howell-Jones, Rebecca, Price, Patricia Elaine, Howard, Anthony J. and Thomas, David William 2006. Antibiotic prescribing for chronic skin wounds in primary care. Wound Repair and Regeneration 14 (4) , pp. 387-393. 10.1111/j.1743-6109.2006.00144.x

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Abstract

The aim of this study was to describe and quantify systemic antibiotic prescribing for patients with chronic skin wounds presenting at the primary care, nonspecialist setting. Data for 1 year were extracted from a general practice morbidity database comprising approximately 185,000 patients attending family medical practitioners in Wales. Patients with chronic wounds (PCW) were identified using Read Codes and compared with nonwound patients who were randomly selected after matching for age-band, sex, and general practice. PCW received a significantly greater number of antibiotic courses than nonwound patients (p<0.001). This increased level of prescribing was evident for flucloxacillin, co-amoxiclav, cefaclor, cefalexin, erythromycin, trimethoprim, metronidazole, and ciprofloxacin (p<0.01 for all). While PCW also had a significantly higher prevalence of diabetes (16.5% compared with 6.6%, p<0.001), and attended at general practice significantly more frequently than nonwound patients (median (interquartile range) of 25 (17–40) visits per year compared with 12 (4–20), p<0.001), importantly, exclusion of diabetic patients and analysis of the proportion of visits on which patients received antibiotics did not affect the significance of the difference in antibiotic consumption. These data show a strong association between occurrence of chronic wounds and prescribing of antibiotics in primary health care, and wide variation in the type and duration of antibiotic therapy for chronic wounds. Further work is now indicated to rationalize this prescribing and determine the role that this exposure to antibiotics plays in the prevalence of antibiotic resistance in this at-risk elderly population.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Healthcare Sciences
Dentistry
Systems Immunity Research Institute (SIURI)
Subjects: R Medicine > RM Therapeutics. Pharmacology
Publisher: Wiley-Blackwell
ISSN: 1067-1927
Last Modified: 09 Apr 2018 20:23
URI: http://orca.cf.ac.uk/id/eprint/30639

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