Journal article
Understanding the gender gap in antibiotic prescribing: a cross-sectional analysis of English primary care
- Abstract:
- OBJECTIVES:To explore the causes of the gender gap in antibiotic prescribing, and to determine whether women are more likely than men to receive an antibiotic prescription per consultation. DESIGN:Cross-sectional analysis of routinely collected electronic medical records from The Health Improvement Network (THIN). SETTING:English primary care. PARTICIPANTS:Patients who consulted general practices registered with THIN between 2013 and 2015. PRIMARY AND SECONDARY OUTCOME MEASURES:Total antibiotic prescribing was measured in children (<19 years), adults (19-64 years) and the elderly (65+ years). For 12 common conditions, the number of adult consultations was measured, and the relative risk (RR) of being prescribed antibiotics when consulting as female or with comorbidity was estimated. RESULTS:Among 4.57 million antibiotic prescriptions observed in the data, female patients received 67% more prescriptions than male patients, and 43% more when excluding antibiotics used to treat urinary tract infection (UTI). These gaps were more pronounced in adult women (99% more prescriptions than men; 69% more when excluding UTI) than in children (9%; 0%) or the elderly (67%; 38%). Among adults, women accounted for 64% of consultations (62% among patients with comorbidity), but were not substantially more likely than men to receive an antibiotic prescription when consulting with common conditions such as cough (RR 1.01; 95% CI 1.00 to 1.02), sore throat (RR 1.01, 95% CI 1.00 to 1.01) and lower respiratory tract infection (RR 1.00, 95% CI 1.00 to 1.01). Exceptions were skin conditions: women were less likely to be prescribed antibiotics when consulting with acne (RR 0.67, 95% CI 0.66 to 0.69) or impetigo (RR 0.85, 95% CI 0.81 to 0.88). CONCLUSIONS:The gender gap in antibiotic prescribing can largely be explained by consultation behaviour. Although in most cases adult men and women are equally likely to be prescribed an antibiotic when consulting primary care, it is unclear whether or not they are equally indicated for antibiotic therapy.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 320.4KB, Terms of use)
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- Publisher copy:
- 10.1136/bmjopen-2017-020203
Authors
- Publisher:
- BMJ
- Journal:
- BMJ Open More from this journal
- Volume:
- 8
- Issue:
- 2
- Pages:
- e020203
- Publication date:
- 2018-02-22
- Acceptance date:
- 2018-01-10
- DOI:
- ISSN:
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2044-6055
- Pmid:
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29472269
- Language:
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English
- Keywords:
- Pubs id:
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pubs:957915
- UUID:
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uuid:1cce0828-19ed-4b7a-af10-762fcf7e0a7f
- Local pid:
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pubs:957915
- Source identifiers:
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957915
- Deposit date:
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2019-04-09
Terms of use
- Copyright holder:
- Crown
- Copyright date:
- 2018
- Notes:
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© 2018 Crown copyright. All rights reserved; no part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior permission of British Medical Journal Open.
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
- Licence:
- CC Attribution (CC BY)
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