Elliot Heward, Eleni Domzaridou, Sean P Gavan, Matthew Carr, Judith Lunn, John Molloy, Rachel Isba, Alastair D Hay, Jaya R Nichani, Iain A Bruce, Darren M Ashcroft
{"title":"英国初级保健中儿科耳疾的发病率、抗菌药处方做法和相关医疗成本：一项纵向人口研究。","authors":"Elliot Heward, Eleni Domzaridou, Sean P Gavan, Matthew Carr, Judith Lunn, John Molloy, Rachel Isba, Alastair D Hay, Jaya R Nichani, Iain A Bruce, Darren M Ashcroft","doi":"10.3399/BJGP.2024.0053","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Paediatric otorrhoea (PO) is a symptom-based diagnosis encompassing acute and chronic ear infections that cause otorrhoea in children and young people (CYP).</p><p><strong>Aim: </strong>To understand the burden of PO on primary care services.</p><p><strong>Design and setting: </strong>This was a longitudinal population study in UK primary care.</p><p><strong>Method: </strong>Data from the Clinical Practice Research Datalink (CPRD Aurum), January 2005 to December 2019, was analysed. CYP <17 years of age with otorrhoea were included. Standardised annual incidence and presentation rates were estimated. Poisson regression modelling was used to determine risk ratios comparing sex, age, and Index of Multiple Deprivation (IMD). A probabilistic simulation scaled-up estimates for the UK population.</p><p><strong>Results: </strong>The cohort included 6 605 193 CYP, observed over 32 942 594 person-years. There were 80 454 people with incident cases and 106 318 presentations of PO during the 15-year period, equating to standardised annual incidence and presentation rates per 1000 patient-years of 2.42 (95% confidence interval [CI] = 2.40 to 2.44) and 3.15 (95% CI 3.13 to 3.17), respectively. In the UK this equates to 41 141 primary care appointments per year. Incidence was higher in males, those aged 0-2 years, and those living in the least deprived quintile. Treatment involved oral antibiotics (57.1%, 45 931/80 454), no prescription (28.1%, 22 569/80 454), topical antibiotics (9.7%, 7797/80 545), or a combination (4.9%, 3910/80 545). The cost to NHS primary care is estimated at £1.97 million per year.</p><p><strong>Conclusion: </strong>To the authors' knowledge, this is the first longitudinal population-based study investigating PO that demonstrates the burden on primary care. Antimicrobial prescribing predominantly follows National Institute for Health and Care Excellence guidelines using oral amoxicillin. Aminoglycosides are the most frequently prescribed topical antibiotic despite the concern of ototoxicity.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e113-e121"},"PeriodicalIF":5.3000,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653408/pdf/","citationCount":"0","resultStr":"{\"title\":\"Incidence, antimicrobial prescribing practice, and associated healthcare costs of paediatric otorrhoea in primary care in the UK: a longitudinal population study.\",\"authors\":\"Elliot Heward, Eleni Domzaridou, Sean P Gavan, Matthew Carr, Judith Lunn, John Molloy, Rachel Isba, Alastair D Hay, Jaya R Nichani, Iain A Bruce, Darren M Ashcroft\",\"doi\":\"10.3399/BJGP.2024.0053\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Paediatric otorrhoea (PO) is a symptom-based diagnosis encompassing acute and chronic ear infections that cause otorrhoea in children and young people (CYP).</p><p><strong>Aim: </strong>To understand the burden of PO on primary care services.</p><p><strong>Design and setting: </strong>This was a longitudinal population study in UK primary care.</p><p><strong>Method: </strong>Data from the Clinical Practice Research Datalink (CPRD Aurum), January 2005 to December 2019, was analysed. CYP <17 years of age with otorrhoea were included. Standardised annual incidence and presentation rates were estimated. Poisson regression modelling was used to determine risk ratios comparing sex, age, and Index of Multiple Deprivation (IMD). A probabilistic simulation scaled-up estimates for the UK population.</p><p><strong>Results: </strong>The cohort included 6 605 193 CYP, observed over 32 942 594 person-years. There were 80 454 people with incident cases and 106 318 presentations of PO during the 15-year period, equating to standardised annual incidence and presentation rates per 1000 patient-years of 2.42 (95% confidence interval [CI] = 2.40 to 2.44) and 3.15 (95% CI 3.13 to 3.17), respectively. In the UK this equates to 41 141 primary care appointments per year. Incidence was higher in males, those aged 0-2 years, and those living in the least deprived quintile. Treatment involved oral antibiotics (57.1%, 45 931/80 454), no prescription (28.1%, 22 569/80 454), topical antibiotics (9.7%, 7797/80 545), or a combination (4.9%, 3910/80 545). The cost to NHS primary care is estimated at £1.97 million per year.</p><p><strong>Conclusion: </strong>To the authors' knowledge, this is the first longitudinal population-based study investigating PO that demonstrates the burden on primary care. Antimicrobial prescribing predominantly follows National Institute for Health and Care Excellence guidelines using oral amoxicillin. 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Incidence, antimicrobial prescribing practice, and associated healthcare costs of paediatric otorrhoea in primary care in the UK: a longitudinal population study.
Background: Paediatric otorrhoea (PO) is a symptom-based diagnosis encompassing acute and chronic ear infections that cause otorrhoea in children and young people (CYP).
Aim: To understand the burden of PO on primary care services.
Design and setting: This was a longitudinal population study in UK primary care.
Method: Data from the Clinical Practice Research Datalink (CPRD Aurum), January 2005 to December 2019, was analysed. CYP <17 years of age with otorrhoea were included. Standardised annual incidence and presentation rates were estimated. Poisson regression modelling was used to determine risk ratios comparing sex, age, and Index of Multiple Deprivation (IMD). A probabilistic simulation scaled-up estimates for the UK population.
Results: The cohort included 6 605 193 CYP, observed over 32 942 594 person-years. There were 80 454 people with incident cases and 106 318 presentations of PO during the 15-year period, equating to standardised annual incidence and presentation rates per 1000 patient-years of 2.42 (95% confidence interval [CI] = 2.40 to 2.44) and 3.15 (95% CI 3.13 to 3.17), respectively. In the UK this equates to 41 141 primary care appointments per year. Incidence was higher in males, those aged 0-2 years, and those living in the least deprived quintile. Treatment involved oral antibiotics (57.1%, 45 931/80 454), no prescription (28.1%, 22 569/80 454), topical antibiotics (9.7%, 7797/80 545), or a combination (4.9%, 3910/80 545). The cost to NHS primary care is estimated at £1.97 million per year.
Conclusion: To the authors' knowledge, this is the first longitudinal population-based study investigating PO that demonstrates the burden on primary care. Antimicrobial prescribing predominantly follows National Institute for Health and Care Excellence guidelines using oral amoxicillin. Aminoglycosides are the most frequently prescribed topical antibiotic despite the concern of ototoxicity.
期刊介绍：
The British Journal of General Practice is an international journal publishing research, editorials, debate and analysis, and clinical guidance for family practitioners and primary care researchers worldwide.
BJGP began in 1953 as the ‘College of General Practitioners’ Research Newsletter’, with the ‘Journal of the College of General Practitioners’ first appearing in 1960. Following the change in status of the College, the ‘Journal of the Royal College of General Practitioners’ was launched in 1967. Three editors later, in 1990, the title was changed to the ‘British Journal of General Practice’. The journal is commonly referred to as the ''BJGP'', and is an editorially-independent publication of the Royal College of General Practitioners.
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