How this fits in

Previous work investigating antibiotic prescribing in primary care has focused primarily on acute antibiotic prescribing, with an emphasis on antibiotic choice and the number of prescriptions issued. This study provides estimates of the overall burden of long-term antibiotic prescriptions in adolescents. This is higher than previously thought, and contributes much more than short-term antibiotics to the number of days of antibiotics used, and is therefore likely to contribute significantly more to the promotion of antibiotic resistance. The use of long-term antibiotics (primarily tetracyclines for acne) contributes significantly to this burden. Non-antibiotic topical treatments are as effective as oral antibiotics for most people with acne, and steps to promote the effective use of these treatments may lead to reductions in antimicrobial resistance without impairing acne outcomes.