Document Detail


Declining antibiotic prescriptions for upper respiratory infections, 1993-2004.
MedLine Citation:
PMID:  17296803     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To examine antibiotic prescribing trends for U.S. emergency department (ED) visits with upper respiratory tract infections (URIs) between 1993 and 2004. METHODS: Data were compiled from the National Hospital Ambulatory Medical Care Survey (NHAMCS). URI visits were identified by using ICD-9-CM code 465.9, whereas antibiotics were identified using the National Drug Code Directory class Antimicrobials. A multivariate logistic regression model revealed sociodemographic and geographic factors that were independently associated with receipt of an antibiotic prescription for URIs. RESULTS: There were approximately 23.4 million ED visits diagnosed as URIs between 1993 and 2004. Although the proportion of URI diagnoses remained relatively stable (ptrend = 0.26), a significant decrease in provision of antibiotic prescriptions for URIs occurred during this 12-year period, from a maximum of 55% in 1993, to a minimum of 35% in 2004. Patients who were prescribed antibiotics were more likely to be white than African American and to have been treated in EDs located in the southern United States. CONCLUSIONS: Antibiotic prescribing for URIs continues to decrease, a favorable trend that suggests that national efforts to reduce inappropriate antibiotic usage are having some success. Nevertheless, the frequency of antibiotic treatment for URI in the ED remains high (35%). Future efforts to reduce inappropriate antibiotic prescribing may focus on patients and physicians in southern U.S. EDs. Additional work is needed to address continued evidence of race-related disparities in care.
Authors:
Stefan G Vanderweil; Andrea J Pelletier; Azita G Hamedani; Ralph Gonzales; Joshua P Metlay; Carlos A Camargo
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.     Date:  2007-02-12
Journal Detail:
Title:  Academic emergency medicine : official journal of the Society for Academic Emergency Medicine     Volume:  14     ISSN:  1553-2712     ISO Abbreviation:  Acad Emerg Med     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-02     Completed Date:  2007-05-04     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9418450     Medline TA:  Acad Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  366-9     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents / therapeutic use*
Child
Child, Preschool
Drug Prescriptions / statistics & numerical data*
Emergency Service, Hospital
Female
Humans
Infant
Logistic Models
Male
Middle Aged
Physician's Practice Patterns / statistics & numerical data*
Respiratory Tract Infections / drug therapy*
United States
Grant Support
ID/Acronym/Agency:
R01 HS013915/HS/AHRQ HHS
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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