PrescQIPP

Reducing course lengths of antibiotics (2025)

Hannage Brook Medical Centre, South Dales PCN

Project summary

South Dales PCN develop an annual workplan which for 2024/25 focused on the National medicines optimisation opportunities.
We selected course length of two commonly prescribed antibiotics (Amoxicillin and Doxycycline) as an area which needed review which had not been looked at previously within the PCN.

Data was easily accessed from OpenPrescribing.net and used to monitor the project and provide feedback to participant practices.
Our search looked for prescriptions issued during a 4 to 6 week time period to provide sufficient data.
Individual patient records were reviewed to identify the prescriber, clinical indication, whether a template was used to prompt prescribing and any documented reason for a longer than 5-day course. Prescriptions for male UTI, skin infections, bronchiectasis or acne were not included in the figures.

A discussion at individual practice meetings involved a reminder of the NICE guidelines and presentation of baseline data. This data was provided down to individual prescriber level. The number of triage sessions (where acute antibiotics are more likely to be prescribed) was also recorded for each prescriber to provide some weighting.
A reminder sheet was provided for clinical rooms on appropriate course lengths and prescribers were encouraged to use the template to prompt 5-day prescribing.

Similar data was then collected 6 months later and presented back to prescribers at one of the practices (Hannage Brook Medical Centre).

The percentage of courses for 5 day prescriptions increased between April and December 2024 across the PCN and each individual practice. However the rate of reduction was high in the PCN than Derbyshire ICB and was particularly noticeable at the practice which was aware they were going to be reaudited at individual prescriber level.

The absolute percentage change in 5 day prescriptions for amoxicillin was:

  • 5% for the ICB, 7% for the PCN and 12% for Hannage Brook

The percentage change in 5 day prescriptions for doxycycline was:

  • 12% for the ICB, 17% for the PCN and 31% for Hannage Brook. 

Fewer doses were prescribed each month which extrapolated to a full year would mean 220 fewer full 5 days courses of Amoxicillin and 280 fewer courses of Doxycycline prescribed across the PCN