Antibiotic Prescribing for Uncomplicated Acute Bronchitis Is Highest in Younger Adults

Antibiotics

Jesal Shah¹  Haijun Wang²  Larissa Grigoryan²  Roger Zoorob²  Barbara W. Trautner³  Monisha Arya³ 

[1] Baylor College of Medicine, Houston, TX 77030, USA;Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX 77098, USA;Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA;

关键词: antimicrobial stewardship;    antimicrobial resistance;    bronchitis;    primary care;   

DOI  :  10.3390/antibiotics6040022

来源: DOAJ

【 摘 要 】

Reducing inappropriate antibiotic prescribing is currently a global health priority. Current guidelines recommend against antibiotic treatment for acute uncomplicated bronchitis. We studied antibiotic prescribing patterns for uncomplicated acute bronchitis and identified predictors of inappropriate antibiotic prescribing. We used the Epic Clarity database (electronic medical record system) to identify all adult patients with acute bronchitis in family medicine clinics from 2011 to 2016. We excluded factors that could justify antibiotic use, such as suspected pneumonia, COPD or immunocompromising conditions. Of the 3616 visits for uncomplicated acute bronchitis, 2244 (62.1%) resulted in antibiotic treatment. The rates of antibiotic prescribing were similar across the years, p value for trend = 0.07. Antibiotics were most frequently prescribed in the age group of 18–39 years (66.9%), followed by the age group of 65 years and above (59.0%), and the age group of 40–64 years (58.7%), p value < 0.001. Macrolides were significantly more likely to be prescribed for younger adults, while fluoroquinolones were more likely to be prescribed for patients 65 years or older. Duration of antibiotic use was significantly longer in older adults. Sex and race were not associated with antibiotic prescribing. Our findings highlight the urgent need to reduce inappropriate antibiotic use for uncomplicated acute bronchitis, particularly in younger adults.

【 授权许可】

Unknown