Factors associated with antibiotic prescriptions for the viral origin diseases in office-based practices, 2006–2012

OBJECTIVE: To test the potential association between time spent with a doctor and antibiotic overprescriptions in case of the common cold, runny nose, bronchitis, chest colds, flu, sore throats, and fluid in the middle ear. DESIGN: Cross-sectional study SETTING: Office-based physicians in the US. PARTICIPANTS: A total of 261,623 patient visits recorded to office-based physicians in the US. MAIN OUTCOME MEASURES: The interest outcome was unnecessary antibiotic prescription. RESULTS: The analysis revealed five significant predictors of antibiotic prescriptions for suspected viral infections: length of doctor–patient encounter time, patient gender, spending time with a family medicine doctor, type of insurance, and the rate of antibiotic prescriptions per physician. For every additional minute a patient spent with a physician during a visit, the mean predicted probability of receiving unnecessary antibiotics decreased by 2.4%. CONCLUSIONS: This study provided evidence that physicians continue to prescribe antibiotics in avoidable cases. Policies that would monitor antibiotic prescription in office-based settings should be considered in order to control spreading of antibiotic resistance and eventually improve population health.