| Title: |
Incidence and treatment of group A streptococcal infections during covid-19 pandemic and 2022 outbreak: retrospective cohort study in England using OpenSAFELY-TPP |
| Authors: |
Cunningham, C; Fisher, L; Wood, C; Speed, V; Brown, AD; Curtis, H; Higgins, R; Croker, R; Butler-Cole, BF; Evans, D; Inglesby, P; Dillingham, I; Bacon, SC; Beech, E; Hand, K; Davy, S; Ward, T; Hickman, G; Bridges, L; O'Dwyer, T; Maude, S; Smith, RM; Mehrkar, A; Hart, LC; Goldacre, B; MacKenna, B |
| Publisher Information: |
BMJ Publishing Group |
| Publication Year: |
2025 |
| Collection: |
Oxford University Research Archive (ORA) |
| Description: |
ObjectiveTo investigate the effect of the covid-19 pandemic on the number of patients with group A streptococcal infections and related antibiotic prescriptions.DesignRetrospective cohort study in England using OpenSAFELY-TPP.SettingPrimary care practices in England that used TPP SystmOne software, 1 January 2018 to 31 March 2023, with the approval of NHS England.ParticipantsPatients registered at a TPP practice at the start of each month of the study period. Patients with missing data for sex or age were excluded, resulting in a population of 23 816 470 in January 2018, increasing to 25 541 940 by March 2023.Main outcome measuresMonthly counts and crude rates of patients with group A streptococcal infections (sore throat or tonsillitis, scarlet fever, and invasive group A streptococcal infections), and recommended firstline, alternative, and reserved antibiotic prescriptions linked with a group A streptococcal infection before (pre-April 2020), during, and after (post-April 2021) covid-19 restrictions. Maximum and minimum count and rate for each infectious season (time from September to August), as well as the rate ratio of the 2022-23 season compared with the last comparably high season (2017-18).ResultsThe number of patients with group A streptococcal infections, and antibiotic prescriptions linked to an indication of group A streptococcal infection, peaked in December 2022, higher than the peak in 2017-18. The rate ratios for monthly sore throat or tonsillitis (possible group A streptococcal throat infection), scarlet fever, and invasive group A streptococcal infection in 2022-23 relative to 2017-18 were 1.39 (95% confidence interval (CI) 1.38 to 1.40), 2.68 (2.59 to 2.77), and 4.37 (2.94 to 6.48), respectively. The rate ratio for prescriptions of first line, alternative, and reserved antibiotics to patients with group A streptococcal infections in 2022-23 relative to 2017-18 were 1.37 (95% CI 1.35 to 1.38), 2.30 (2.26 to 2.34), and 2.42 (2.24 to 2.61), respectively. For individual antibiotic prescriptions ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1136/bmjmed-2023-000791 |
| Availability: |
https://doi.org/10.1136/bmjmed-2023-000791; https://ora.ox.ac.uk/objects/uuid:9ce22e72-edc5-44ad-a976-3d16a6b82b96 |
| Rights: |
info:eu-repo/semantics/openAccess ; CC Attribution (CC BY) |
| Accession Number: |
edsbas.D49C10C5 |
| Database: |
BASE |