Variability of Antibiotic Prescribing in a Large Healthcare Network Despite Adjusting for Patient-Mix: Reconsidering Targets for Improved Prescribing

Open Forum Infectious Diseases
Sophia JungScott Fridkin

Abstract

In the outpatient setting, the majority of antibiotic prescriptions are for acute respiratory infections (ARIs), but most of these infections are viral and antibiotics are unnecessary. We analyzed provider-specific antibiotic prescribing in a group of outpatient clinics affiliated with an academic medical center to inform future interventions to minimize unnecessary antibiotic use. We conducted a cross-sectional study of patients who presented with an ARI to any of 15 The Emory Clinic (TEC) primary care clinic sites between October 2015 and September 2017. We performed multivariable logistic regression analysis to examine the impact of patient, provider, and clinic characteristics on antibiotic prescribing. We also compared provider-specific prescribing rates within and between clinic sites. A total of 53.4% of the 9600 patient encounters with a diagnosis of ARI resulted in an antibiotic prescription. The odds of an encounter resulting in an antibiotic prescription were independently associated with patient characteristics of white race (adjusted odds ratio [aOR] = 1.59; 95% confidence interval [CI], 1.47-1.73), older age (aOR = 1.32, 95% CI = 1.20-1.46 for patients 51 to 64 years; aOR = 1.32, 95% CI = 1.20-1.46 for patients ≥6...Continue Reading

References

Feb 15, 2003·JAMA : the Journal of the American Medical Association·Michael A SteinmanRalph Gonzales
Apr 2, 2003·Annals of Internal Medicine·Michael A SteinmanC Seth Landefeld
May 15, 2003·The Journal of Antimicrobial Chemotherapy·Claudia ThomasThomas V Riley
Dec 23, 2003·The Pediatric Infectious Disease Journal·Jay M Lieberman
Apr 7, 2005·Clinical Therapeutics·Sherrie L AspinallJoshua P Metlay
Jul 30, 2005·Journal of General Internal Medicine·Christianne L RoumieMarie R Griffin
Jul 4, 2006·American Journal of Infection Control·Fred C Tenover
Jan 4, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Brad SpellbergUNKNOWN Infectious Diseases Society of America
Aug 13, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Nadine ShehabDaniel S Budnitz
Aug 20, 2009·JAMA : the Journal of the American Medical Association·Carlos G GrijalvaMarie R Griffin
Aug 8, 2012·Annals of Internal Medicine·Sara Ackerman, Ralph Gonzales
Jul 28, 2013·The Journal of Antimicrobial Chemotherapy·Daniel J ShapiroAdam L Hersh
Aug 13, 2013·American Journal of Infection Control·Jocelyn A SrigleyDominik Mertz
Oct 29, 2013·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Scott K Fridkin, Arjun Srinivasan
Dec 18, 2013·Antimicrobial Agents and Chemotherapy·John P DonnellyHenry E Wang
Mar 10, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Lauri A HicksStephanie J Schrag
Apr 4, 2015·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Richard M RosenfeldMaureen D Corrigan
Feb 13, 2016·JAMA : the Journal of the American Medical Association·Daniella MeekerJason N Doctor
Apr 14, 2016·Journal of General Internal Medicine·Courtney A GidengilJeffrey A Linder
May 4, 2016·JAMA : the Journal of the American Medical Association·Katherine E Fleming-DutraLauri A Hicks
May 25, 2016·Expert Review of Anti-infective Therapy·Carl Llor, Lars Bjerrum
Jan 31, 2017·Progress in Cardiovascular Diseases·Shane A PhillipsRoss Arena
Jul 14, 2017·The Medical Journal of Australia·Amanda R McCulloughChristopher B Del Mar
Sep 6, 2017·Pediatrics·Monika K GoyalUNKNOWN Pediatric Care Applied Research Network (PECARN)

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Citations

Oct 22, 2019·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Courtney M PagelsCharles F Brummitt
Jan 28, 2020·American Journal of Veterinary Research·Laurel E ReddingRose D Nolen-Walston
Jan 9, 2020·Critical Care Medicine·Federico AngrimanAndre Carlos Kajdacsy-Balla Amaral
Oct 23, 2019·The Journal of Antimicrobial Chemotherapy·Beth StuartPaul Little
Jun 27, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Haley J AppanealKerry L LaPlante
Feb 8, 2021·The Journal of Hospital Infection·H J AppanealT I Shireman
Mar 23, 2021·American Journal of Preventive Medicine·Colin C HubbardKatie J Suda

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