Risk Factors for Unnecessary Antibiotic Prescribing for Acute Respiratory Tract Infections in Primary Care
Objective: To determine independent risk factors for inappropriate antibiotic prescribing for acute respiratory tract infections (ARIs) in internal medicine (IM) residency–based primary care offices. Patients and Methods: A retrospective study was conducted to measure antibiotic prescribing rates, a...
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Format: | Article |
Language: | English |
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Elsevier
2020-02-01
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Series: | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
Online Access: | http://www.sciencedirect.com/science/article/pii/S2542454819301481 |
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author | Thomas L. Walsh, MD Kevin Taffe, MD, PhD Nicole Sacca, DO Derek N. Bremmer, PharmD, BCPS Mary Lynn Sealey, MD Elizabeth Cuevas, MD Alexandra Johnston, DO Alyson Malarkey, DO Rebecca Behr, DO Jessica Embrescia, DO Ekknoor Sahota, MD Sara Loucks, DO Nupur Gupta, DO Kelly J. Shields, PhD Curren Katz, PhD Anastasios Kapetanos, MD |
author_facet | Thomas L. Walsh, MD Kevin Taffe, MD, PhD Nicole Sacca, DO Derek N. Bremmer, PharmD, BCPS Mary Lynn Sealey, MD Elizabeth Cuevas, MD Alexandra Johnston, DO Alyson Malarkey, DO Rebecca Behr, DO Jessica Embrescia, DO Ekknoor Sahota, MD Sara Loucks, DO Nupur Gupta, DO Kelly J. Shields, PhD Curren Katz, PhD Anastasios Kapetanos, MD |
author_sort | Thomas L. Walsh, MD |
collection | DOAJ |
description | Objective: To determine independent risk factors for inappropriate antibiotic prescribing for acute respiratory tract infections (ARIs) in internal medicine (IM) residency–based primary care offices. Patients and Methods: A retrospective study was conducted to measure antibiotic prescribing rates, and multivariable analysis was utilized to identify predictors of inappropriate prescribing among patients presenting to IM residency–based primary care office practices. Patients with an office visit at either of 2 IM residency–based primary care office practices from January 1, 2016, through December 31, 2016, with a primary encounter diagnosis of ARI were included. Results: During the study period, 911 unique patient encounters were included with 518 for conditions for which antibiotics were considered always inappropriate. Antibiotics were not indicated in 85.8% (782 of 911) of encounters. However, antibiotics were prescribed in 28.4% (222 of 782) of these encounters. Inappropriate antibiotic prescribing occurred in 111 of 518 (21.4%) encounters for conditions for which antibiotics are always inappropriate. Using multivariable logistic regression analysis to assess for independent risk factors when adjusted for other potential risk factors for office visits at which antibiotics were not indicated, IM resident–associated visits (odds ratio, 0.25; 95% CI, 0.18-0.36) was the only variable independently associated with lower risk of inappropriate antibiotic prescribing. Conclusion: For ARI visits at which antibiotics were not indicated, IM resident comanagement was associated with lower rates of inappropriate prescribing. |
first_indexed | 2024-12-11T19:54:32Z |
format | Article |
id | doaj.art-3ab67e232b32488ab0b9c0a83c3cae36 |
institution | Directory Open Access Journal |
issn | 2542-4548 |
language | English |
last_indexed | 2024-12-11T19:54:32Z |
publishDate | 2020-02-01 |
publisher | Elsevier |
record_format | Article |
series | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
spelling | doaj.art-3ab67e232b32488ab0b9c0a83c3cae362022-12-22T00:52:40ZengElsevierMayo Clinic Proceedings: Innovations, Quality & Outcomes2542-45482020-02-01413139Risk Factors for Unnecessary Antibiotic Prescribing for Acute Respiratory Tract Infections in Primary CareThomas L. Walsh, MD0Kevin Taffe, MD, PhD1Nicole Sacca, DO2Derek N. Bremmer, PharmD, BCPS3Mary Lynn Sealey, MD4Elizabeth Cuevas, MD5Alexandra Johnston, DO6Alyson Malarkey, DO7Rebecca Behr, DO8Jessica Embrescia, DO9Ekknoor Sahota, MD10Sara Loucks, DO11Nupur Gupta, DO12Kelly J. Shields, PhD13Curren Katz, PhD14Anastasios Kapetanos, MD15Department of Medicine, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA; Division of Infectious Diseases, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA; Department of Medicine and Division of Infectious Diseases, Western Pennsylvania Hospital, Allegheny Health Network, Pittsburgh; Correspondence: Address to Thomas L. Walsh, MD, Allegheny General Hospital, 320 E North Ave, 4th Floor East Wing, Ste 406, Pittsburgh, PA 15212.Department of Medicine, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PADepartment of Medicine, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PADepartment of Pharmacy, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PADepartment of Medicine, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PADepartment of Medicine, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PADepartment of Medicine, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PADepartment of Medicine, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PADepartment of Medicine, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PADepartment of Medicine, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PADepartment of Medicine, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PADepartment of Medicine, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PADepartment of Medicine, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PAData Science R&D, Highmark Health, Pittsburgh, PAData Science R&D, Highmark Health, Pittsburgh, PADepartment of Medicine, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PAObjective: To determine independent risk factors for inappropriate antibiotic prescribing for acute respiratory tract infections (ARIs) in internal medicine (IM) residency–based primary care offices. Patients and Methods: A retrospective study was conducted to measure antibiotic prescribing rates, and multivariable analysis was utilized to identify predictors of inappropriate prescribing among patients presenting to IM residency–based primary care office practices. Patients with an office visit at either of 2 IM residency–based primary care office practices from January 1, 2016, through December 31, 2016, with a primary encounter diagnosis of ARI were included. Results: During the study period, 911 unique patient encounters were included with 518 for conditions for which antibiotics were considered always inappropriate. Antibiotics were not indicated in 85.8% (782 of 911) of encounters. However, antibiotics were prescribed in 28.4% (222 of 782) of these encounters. Inappropriate antibiotic prescribing occurred in 111 of 518 (21.4%) encounters for conditions for which antibiotics are always inappropriate. Using multivariable logistic regression analysis to assess for independent risk factors when adjusted for other potential risk factors for office visits at which antibiotics were not indicated, IM resident–associated visits (odds ratio, 0.25; 95% CI, 0.18-0.36) was the only variable independently associated with lower risk of inappropriate antibiotic prescribing. Conclusion: For ARI visits at which antibiotics were not indicated, IM resident comanagement was associated with lower rates of inappropriate prescribing.http://www.sciencedirect.com/science/article/pii/S2542454819301481 |
spellingShingle | Thomas L. Walsh, MD Kevin Taffe, MD, PhD Nicole Sacca, DO Derek N. Bremmer, PharmD, BCPS Mary Lynn Sealey, MD Elizabeth Cuevas, MD Alexandra Johnston, DO Alyson Malarkey, DO Rebecca Behr, DO Jessica Embrescia, DO Ekknoor Sahota, MD Sara Loucks, DO Nupur Gupta, DO Kelly J. Shields, PhD Curren Katz, PhD Anastasios Kapetanos, MD Risk Factors for Unnecessary Antibiotic Prescribing for Acute Respiratory Tract Infections in Primary Care Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
title | Risk Factors for Unnecessary Antibiotic Prescribing for Acute Respiratory Tract Infections in Primary Care |
title_full | Risk Factors for Unnecessary Antibiotic Prescribing for Acute Respiratory Tract Infections in Primary Care |
title_fullStr | Risk Factors for Unnecessary Antibiotic Prescribing for Acute Respiratory Tract Infections in Primary Care |
title_full_unstemmed | Risk Factors for Unnecessary Antibiotic Prescribing for Acute Respiratory Tract Infections in Primary Care |
title_short | Risk Factors for Unnecessary Antibiotic Prescribing for Acute Respiratory Tract Infections in Primary Care |
title_sort | risk factors for unnecessary antibiotic prescribing for acute respiratory tract infections in primary care |
url | http://www.sciencedirect.com/science/article/pii/S2542454819301481 |
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