Antibiotic stewardship: courses for amoxicillin 500mg greater than 15 capsules

Below are the database queries which are used to create this measure. These are run against a copy of the BSA prescribing data which we store in Google BigQuery. We're working on making our BigQuery tables publicly available at which point it will be possible to run and modify these queries yourself. But even where code and database queries are not directly useable by others we believe it is always preferable to make them public.

Description Proportion of prescription items of amoxicillin 500mg capsules with quantity greater than 15 capsules
Why it matters The most common indication for the prescribing of amoxicillin in primary care is the treatment of respiratory-tract infections. NICE guidance recommends for example that, where amoxicillin is used for cough, the dose is 500mg three times a day for 5 days. Where greater than 5 days treatment is prescribed for these indications, this increases both the unnecessary prescribing of antibiotics, as well as cost. There are however some indications which require higher doses/longer durations of amoxicillin for example, treatment of H. pylori.

NHS England National Medicines Optimisation Opportunities for 2023/24 identify use of the shortest effective antibiotic courses as an area for improvement, and suggests that 75% of amoxicillin prescriptions should be 5-day courses by March 2024.
Tags Antimicrobial Stewardship, Standard, Infections, NICE, National medicines optimisation opportunities
Implies cost savings No
Authored by richard.croker
Checked by christopher.wood
Last reviewed 2023-09-12
Next review due 2025-09-12
History View change history on GitHub →

Numerator SQL

SELECT
     CAST(month AS DATE) AS month,
     practice AS practice_id,
     SUM(items) AS numerator
 FROM hscic.raw_prescribing_normalised
 WHERE bnf_code LIKE '0501013B0%AB' AND quantity_per_item > 15 --Amoxicillin 500mg capsules (brands and generic)
 GROUP BY month, practice_id

Denominator SQL

SELECT
     CAST(month AS DATE) AS month,
     practice AS practice_id,
     SUM(items) AS denominator
 FROM hscic.raw_prescribing_normalised
 WHERE bnf_code LIKE '0501013B0%AB' --Amoxicillin 500mg capsules (brands and generic)
 GROUP BY month, practice_id
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