Risk Factors for Unnecessary Antibiotic Prescribing for Acute Respiratory Tract Infections in Primary Care
| Autor: | Kelly J. Shields, Rebecca Behr, Derek N Bremmer, Jessica Embrescia, Mary Lynn Sealey, Ekknoor Sahota, Curren Katz, Nicole Sacca, Elizabeth Cuevas, Alexandra Johnston, Sara Loucks, Anastasios Kapetanos, Alyson Malarkey, Nupur Gupta, Kevin Taffe, Thomas L. Walsh |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class AHN Allegheny Health Network Antibiotics ICD-10-CM International Classification of Diseases Tenth Revision Clinical Modification URI upper respiratory tract infection 030204 cardiovascular system & hematology Lower risk Logistic regression IM internal medicine 03 medical and health sciences 0302 clinical medicine ICD-9-CM International Classification of Diseases Ninth Revision Clinical Modification EHR electronic health record medicine 030212 general & internal medicine Acute respiratory tract infection lcsh:R5-920 Respiratory tract infections business.industry Retrospective cohort study Odds ratio medicine.disease OR odds ratio Upper respiratory tract infection Emergency medicine Original Article business lcsh:Medicine (General) ARI acute respiratory tract infection ASP antimicrobial stewardship program |
| Zdroj: | Mayo Clinic Proceedings: Innovations, Quality & Outcomes, Vol 4, Iss 1, Pp 31-39 (2020) Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| ISSN: | 2542-4548 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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