Antibiotic Prescribing and Sociodemographic Deprivation – From General Index to Specific Domains

Objectives: Analyse the variance associated with the domains of the English Index of Multiple Deprivation (2015) as predictors of antibiotic prescribing. Methods: Deprivation and prescribing data for Clinical Commissioning Groups in England were collected, tabulated and used to build regression models characterising the relationship between antibiotic prescribing and indices of deprivation in the domains of education, health, employment, income, services and living environment. Results: The Index and 6 out of the 7 deprivation domains predicted antibiotic prescribing as reported (<0.001) and explained 21-38% of the variance. The domain of Education, Training and Skills emerged as a key factor (R2=0.38266) whereas employment explained as much variance in prescribing as health (R2=0.23408 and 0.23549 respectively). Conclusions: Individual indices of deprivation such as education and employment can account for the variance in antibiotic prescribing to a similar or a greater extent than health or the Index as a whole. Predictive indices provide new insights into the ways in which socio-demographic deprivation affects prescribing and can serve in the design of future more targeted interventions, such as those to lower unwarranted antibiotic prescribing.