{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T09:30:05Z","timestamp":1740130205825,"version":"3.37.3"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"5-6","license":[{"start":{"date-parts":[[2023,5,6]],"date-time":"2023-05-06T00:00:00Z","timestamp":1683331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Insect bite inflammation may mimic cellulitis and promote unnecessary antibiotic usage, contributing to antimicrobial resistance in primary care. We wondered how general practice clinicians assess and manage insect bites, diagnose cellulitis, and prescribe antibiotics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>This is a Quality Improvement study in which 10 general practices in England and Wales investigated patients attending for the first time with insect bites between April and September 2021 to their practices. Mode of consultation, presentation, management plan, and reattendance or referral were noted. Total practice flucloxacillin prescribing was compared to that for insect bites.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A combined list size of 161,346 yielded 355 insect bite consultations. Nearly two-thirds were female, ages 3\u201389 years old, with July as the peak month and a mean weekly incidence of 8 per 100,000. GPs still undertook most consultations; most were phone consultations, with photo support for over half. Over 40% presented between days 1 and 3 and common symptoms were redness, itchness, pain, and heat. Vital sign recording was not common, and only 22% of patients were already taking an antihistamine despite 45% complaining of itch. Antibiotics were prescribed to nearly three-quarters of the patients, mainly orally and mostly as flucloxacillin. Reattendance occurred for 12% and referral to hospital for 2%. Flucloxacillin for insect bites contributed a mean of 5.1% of total practice flucloxacillin prescriptions, with a peak of 10.7% in July.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Antibiotics are likely to be overused in our insect bite practice and patients could make more use of antihistamines for itch before consulting.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/fampra\/cmad051","type":"journal-article","created":{"date-parts":[[2023,5,6]],"date-time":"2023-05-06T11:19:55Z","timestamp":1683371995000},"page":"753-759","source":"Crossref","is-referenced-by-count":0,"title":["Are insect bites responsible for the rise in summer flucloxacillin prescribing in United Kingdom general practices?"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0086-4688","authenticated-orcid":false,"given":"Jane","family":"Wilcock","sequence":"first","affiliation":[{"name":"GP Silverdale Medical Practice, Silverdale Medical Practice , Salford , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamila","family":"Hawthorne","sequence":"additional","affiliation":[{"name":"Professor, Academic Office\u2014312 Second Floor Grove Building Singleton Campus, Swansea University Medical School , Wales , United Kingdom"},{"name":"GP, Meddygfa Glan Cynon, Cynon Vale Medical Practice , Ty Calon Lan, Oxford Street, Mountain Ash, Wales , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3184-7955","authenticated-orcid":false,"given":"Joanne","family":"Reeve","sequence":"additional","affiliation":[{"name":"Professor, Hull York Medical School, Academy of Primary Care , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare","family":"Etherington","sequence":"additional","affiliation":[{"name":"GP, Ridgeway Surgery , Harrow, London , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharine","family":"Alsop","sequence":"additional","affiliation":[{"name":"GP, Nightingale Valley Practice , Brislington, Bristol , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"Bircher","sequence":"additional","affiliation":[{"name":"GP, Lockside Medical Centre , Stalybridge, Tameside , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas","family":"McKechnie","sequence":"additional","affiliation":[{"name":"GP, University College London, Research Department of Primary Care and Population Health; Holborn Medical Centre , London , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Granier","sequence":"additional","affiliation":[{"name":"GP, Whiteladies Medical Group , Whatley Road, Clifton, Bristol , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Newport","sequence":"additional","affiliation":[{"name":"Medicine Trainee, University Hospitals Birmingham NHS Foundation Trust , Birmingham , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Wright","sequence":"additional","affiliation":[{"name":"GP, Walkden Medical Practice , Salford , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Larcombe","sequence":"additional","affiliation":[{"name":"GP, Sedgefield , Co Durham , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chinonso","family":"Ndukauba","sequence":"additional","affiliation":[{"name":"GP, Whiteladies Medical Group, Whiteladies , Whatley Road, Clifton, Bristol , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nitharnie","family":"Anastasius","sequence":"additional","affiliation":[{"name":"GP Ridgeway Surgery , Harrow, London , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,5,6]]},"reference":[{"issue":"7","key":"2023122219180766500_CIT0001","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.1093\/jac\/dkw084","article-title":"Understanding flucloxacillin prescribing trends and treatment non-response in UK primary care: a Clinical Practice Research Datalink (CPRD) study","volume":"71","author":"Francis","year":"2016","journal-title":"J Antimicrob 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