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Antibiotic prescribing and antibiotic resistance in community practice: retrospective study, 1996-8

BMJ 1999; 319 doi: (Published 06 November 1999) Cite this as: BMJ 1999;319:1239
  1. J T Magee, clinical scientista,
  2. Emma L Pritchard, medical studentb,
  3. Karen A Fitzgerald, pharmaceutical adviserc,
  4. F D J Dunstan, senior lecturerd,
  5. A J Howard, group director, PHLS Wales, on behalf of the Welsh Antibiotic Study Group (
  1. a Department of Medical Microbiology and Public Health Laboratory, University Hospital of Wales, Cardiff CF14 4XW
  2. b University of Wales College of Medicine, Cardiff CF14 4XW
  3. c Bro Taf Health Authority, Cardiff CF1 4TW
  4. d Department of Medical Computing and Statistics, University of Wales College of Medicine
  1. Correspondence to: A J Howard
  • Accepted 19 July 1999

We describe a retrospective survey of antibiotic prescribing in general practitioners' surgeries and resistance to antibiotics in Wales from March 1996 to April 1998.

Methods and results

Data on the susceptibility to antibiotics of coliform organisms in routine urine samples taken by general practitioners for diagnosis of urinary tract infections were collected from the Bangor, Cardiff, and Rhyl Public Health Laboratories and the East Glamorgan, Prince Charles, and Wrexham Maelor Hospitals. Data on the prescribing practices of surgeries were obtained from the Welsh Prescription Pricing Service Rates of prescribing (the number of prescriptions/1000 patients per year) and resistance rates (which excluded multiple isolates of organisms with the same susceptibility from the same patient) were calculated for each surgery. The use of broad spectrum penicillin formulations without a β lactamase inhibitor (such as ampicillin and amoxicillin) was estimated by subtracting the number of prescriptions for co-amoxiclav from the total number of prescriptions for all other broad spectrum penicillins. We use the term amoxicillin below to refer to these broad spectrum penicillins without a β lactamase inhibitor.

Resistance rates for surgeries which were based on fewer than 50 isolates were excluded, leaving data on about 30 000 isolates …

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