Antibiotic stewardship: Injectable preparations for the treatment of infection

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 Number of prescription items for all injectable medicines in BNF Chapter 5 (infections) excluding colistimethate sodium per 1000 patients
Why it matters

It is important that we don't overuse antibiotics. As antimicrobials underpin routine medical practice, antimicrobial resistance poses a significant threat to public health. This measure shows the use of injectable preparations listed in the infections chapter of the British National Formulary, including antibiotics, antivirals and antifungals. We have excluded colistimethate sodium, as the injection is more commonly inhaled for the treatment of infections in people with cystic fibrosis.

The prescribing of injectable preparations may vary substantially throughout the country depending on the availability of local services such as Antibiotic Outpatient Parenteral Therapy (OPAT), where patients receive injectable antibiotics in their own home. Nevertheless it is important to audit and review the appropriateness of all treatments to support good antimicrobial stewardship.
Tags Antimicrobial Stewardship, Standard, Infections
Implies cost savings No
Authored by brian.mackenna
Checked by andrew.brown
Last reviewed 2024-02-06
Next review due 2026-02-06
Associated notebook https://github.com/ebmdatalab/antibiotics-non-oral-routes-notebook/blob/master/notebooks/injections.ipynb
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.normalised_prescribing
 WHERE bnf_code IN ("0501011J0AAABAB", "0501011J0AAAFAF", "0501011J0BBABAB", "0501012G0AAACAC", "0501012G0AAADAD", "0501012G0AAAEAE", "0501012G0AAARAR", "0501012U0AAABAB", "0501013C0AAACAC", "0501013C0AAADAD", "0501013C0AAAEAE", "0501013C0BCABAD", "0501013C0BCACAE", "0501013E0AAADAD", "0501013K0AAAEAE", "0501013K0AAAFAF", "0501013K0BBACAE", "0501013K0BBAHAF", "0501014N0BBACAC", "0501014S0AAAAAA", "0501014S0AAABAB", "0501014S0BBAAAA", "0501014S0BBABAB", "0501021D0AAAAAA", "0501021D0AAABAB", "0501021D0AAACAC", "0501021G0AAABAB", "0501021G0AAACAC", "0501021G0AAADAD", "0501021G0BBAAAB", "0501021G0BBABAC", "0501021G0BBACAD", "0501021H0AAAAAA", "0501021H0AAABAB", "0501021H0AAACAC", "0501021H0AAAHAH", "0501021H0BBABAA", "0501021H0BBACAB", "0501021H0BBAGAH", "0501021J0AAAAAA", "0501021J0AAABAB", "0501021J0AAACAC", "0501021J0BBAAAA", "0501021J0BBABAB", "0501022A0AAAAAA", "0501022A0AAABAB", "0501022A0BBAAAA", "0501022A0BBABAB", "0501022B0AAAAAA", "0501022B0BBAAAA", "0501030Y0AAAAAA", "0501040C0AAAAAA", "0501040C0AAADAD", "0501040C0BBACAD", "0501040H0AAAAAA", "0501040H0AAAEAE", "0501040H0AAAHAH", "0501040H0AAAMAM", "0501040H0AAAQAQ", "0501040H0AABBBB", "0501040H0AABCBC", "0501040H0BBAAAA", "0501040H0BBAFAM", "0501040H0BCAAAA", "0501040H0BGAAAE", "0501040U0AAABAB", "0501040U0AAACAC", "0501040U0AAAIAI", "0501040U0BBACAC", "0501050B0AAACAC", "0501050B0BBACAC", "0501050K0AAAAAA", "0501060E0AAAAAA", "0501060E0AAABAB", "0501060E0BBAAAA", "0501070F0AAACAC", "0501070N0AAABAB", "0501070T0AAAAAA", "0501070T0AAABAB", "0501070T0AAACAC", "0501070T0AAADAD", "0501070T0BBAAAA", "0501070T0BBABAB", "0501070U0AAACAC", "0501070U0AAAFAF", "0501070U0BBADAC", "0501070U0BBAEAF", "0501070Y0AAAAAA", "0501070Y0AAABAB", "0501070Y0BBAAAA", "0501080D0AAABAB", "0501110C0AAAKAK", "0501110C0AABABA", "0501120L0AAABAB", "0501120L0AAADAD", "0501120L0AABEBE", "0501120L0AABFBF", "0501120L0AABQBQ", "0501120X0AAADAD", "0502010A0AAACAC", "0502010B0AAADAD", "0502010B0AAAEAE", "0502010B0AAALAL", "0502010B0AAAMAM", "0502010D0AAACAC", "0502030A0AAAAAA", "0502030A0BCAAAA", "0502040C0AAAAAA", "0502040C0AAABAB", "0503010AWAAABAB", "0503021C0AAAIAI", "0503050A0AAACAC", "0503050A0BBADAD", "0504080P0AAAAAA")
 GROUP BY month, practice_id

Denominator SQL

SELECT
     CAST(month AS DATE) AS month,
     practice AS practice_id,
     SUM(total_list_size / 1000.0) AS denominator
 FROM hscic.practice_statistics
 GROUP BY month, practice_id
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