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Antibiotic Prescribing for Uncomplicated Acute Bronchitis Is Highest in Younger Adults

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...

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Autores principales: Grigoryan, Larissa, Zoorob, Roger, Shah, Jesal, Wang, Haijun, Arya, Monisha, Trautner, Barbara W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5745465/
https://www.ncbi.nlm.nih.gov/pubmed/29077003
http://dx.doi.org/10.3390/antibiotics6040022
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author Grigoryan, Larissa
Zoorob, Roger
Shah, Jesal
Wang, Haijun
Arya, Monisha
Trautner, Barbara W.
author_facet Grigoryan, Larissa
Zoorob, Roger
Shah, Jesal
Wang, Haijun
Arya, Monisha
Trautner, Barbara W.
author_sort Grigoryan, Larissa
collection PubMed
description 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.
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spelling pubmed-57454652018-01-02 Antibiotic Prescribing for Uncomplicated Acute Bronchitis Is Highest in Younger Adults Grigoryan, Larissa Zoorob, Roger Shah, Jesal Wang, Haijun Arya, Monisha Trautner, Barbara W. Antibiotics (Basel) Article 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. MDPI 2017-10-27 /pmc/articles/PMC5745465/ /pubmed/29077003 http://dx.doi.org/10.3390/antibiotics6040022 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Grigoryan, Larissa
Zoorob, Roger
Shah, Jesal
Wang, Haijun
Arya, Monisha
Trautner, Barbara W.
Antibiotic Prescribing for Uncomplicated Acute Bronchitis Is Highest in Younger Adults
title Antibiotic Prescribing for Uncomplicated Acute Bronchitis Is Highest in Younger Adults
title_full Antibiotic Prescribing for Uncomplicated Acute Bronchitis Is Highest in Younger Adults
title_fullStr Antibiotic Prescribing for Uncomplicated Acute Bronchitis Is Highest in Younger Adults
title_full_unstemmed Antibiotic Prescribing for Uncomplicated Acute Bronchitis Is Highest in Younger Adults
title_short Antibiotic Prescribing for Uncomplicated Acute Bronchitis Is Highest in Younger Adults
title_sort antibiotic prescribing for uncomplicated acute bronchitis is highest in younger adults
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5745465/
https://www.ncbi.nlm.nih.gov/pubmed/29077003
http://dx.doi.org/10.3390/antibiotics6040022
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