Antibiotic prescribing: the need for a policy in general practice.

OBJECTIVE To see whether changes in prescribing of oral antibacterials in Northern Ireland show the need for a community antibiotics policy. DESIGN Analysis of prescribing totals for several oral antibiotics obtained retrospectively from the prescription pricing bureau for the years 1983-7. SETTING Audit of anti-infective prescribing in general practice in Northern Ireland over five years. MAIN OUTCOME MEASURE Respective usage of agents defined as "common" and "occasional" in 1983. RESULTS There was a gradual decrease in the relative use of common agents from 82% of the total in 1983 to 77% in 1987 together with a complementary increase in the use of occasional agents from 5% to 10%. Pronounced changes were noted in the use of amoxycillin, ampicillin, erythromycin, minocycline, doxycycline, and amoxycillin-clavulanic acid. CONCLUSION Though this survey found reasonably conservative prescribing, the trend towards increased use of occasional agents has both clinical and cost implications which could be addressed by the use of a prescribing formulary.