• S Smith, G E Smith, H Heatlie, J N R Bashford, D M Ashcroft, N Q Verlander, G J Duckworth, B Mason, B Smyth, and S Maxwell.
• Regional Surveillance Unit, Health Protection Agency West Midlands, Birmingham, UK. sue.smith@hpa.org.uk
• Public Health. 2006 Aug 1;120(8):752-9.

ObjectiveTo use the General Practice Research Database (GPRD) to explore the regional variation in prescribing for single diagnostic episodes of 'cough/cold' and sore throat and how this changed between 1993 and 2001.MethodsData from the GPRD was used to conduct a longitudinal survey of morbidity and antibiotic prescribing data.ResultsNationally there has been a substantial reduction in diagnosed episodes per 1000 patient years at risk for both diagnoses: from 104.6 (104.0-105.2) to 86.5 (86.0-86.9) for cough/cold (-17.3%) and from 102.8 (102.2-103.4) to 69.2 (68.8-69.6) for sore throat (-32.6%). In addition to the changes in diagnostic rate there have been reductions in diagnosis-related prescribing: from 41.8% to 34.8% of cough/cold episodes (-7.0%) and from 77.3% to 60.8% of sore throat episodes (-16.4%). These aggregated data conceal wide regional variations. For cough/cold the change in prescribing rate during the study varied from -16.0% to +5.3% and for sore throat from -28.3% to -7.3%.ConclusionsIn addition to a substantial reduction in diagnosis of cough/cold and sore throat, there has been a reduction in diagnosis-related prescribing episodes in almost all regions. Although there continues to be regional variation in diagnosis-related prescribing this has reduced substantially over the 9-year study period.

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