Antibiotic and antitussive prescribing among urgent care and emergency department visits for respiratory diagnoses in a large health system

OBJECTIVE: Urgent care centers (UCs) commonly evaluate patients with respiratory infections, and patients increasingly prefer UCs to emergency departments (EDs) because of their customer‐centric approach. The aim of this study is to describe antibiotic and opioid prescribing among UC and ED visits w...

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Autores principales: Zakharevich, Marina, Kippenhan, Matthew A., Lu, Alice, Courtney, D. Mark, McCarthy, Danielle M., Kim, Howard S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9149652/
https://www.ncbi.nlm.nih.gov/pubmed/35662900
http://dx.doi.org/10.1002/emp2.12741
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author Zakharevich, Marina
Kippenhan, Matthew A.
Lu, Alice
Courtney, D. Mark
McCarthy, Danielle M.
Kim, Howard S.
author_facet Zakharevich, Marina
Kippenhan, Matthew A.
Lu, Alice
Courtney, D. Mark
McCarthy, Danielle M.
Kim, Howard S.
author_sort Zakharevich, Marina
collection PubMed
description OBJECTIVE: Urgent care centers (UCs) commonly evaluate patients with respiratory infections, and patients increasingly prefer UCs to emergency departments (EDs) because of their customer‐centric approach. The aim of this study is to describe antibiotic and opioid prescribing among UC and ED visits with respiratory diagnoses. METHODS: This is a cross‐sectional study of visits to 7 EDs and 6 UCs in the greater Chicago area. We included visits from July 1, 2017, to June 30, 2019, with a primary diagnosis of upper or lower respiratory infection. We describe the proportion of visits resulting in an antibiotic or antitussive prescription as well as the most frequently prescribed medications in these categories. We also describe the demographic and clinical characteristics of visits. RESULTS: Of 9134 ED visits, 32.9% were prescribed an antibiotic and 14.4% an antitussive (6.6% opioid). Of 41,380 UC visits for respiratory diagnoses, 57.9% were prescribed an antibiotic and 25.0% an antitussive (9.3% opioid). The most frequently prescribed antibiotics among ED and UC visits were penicillins (36.6% and 44.5%, respectively) and macrolides (44.1% and 35.3%, respectively). The most commonly prescribed opioid was codeine (55.6% and 91.0%, respectively). Median waiting room time was 16 and 5 minutes for ED and UC visits, respectively; median length of stay was 178 and 41 minutes, respectively. CONCLUSIONS: Antibiotics and antitussives, including opioids, are frequently prescribed for ED and UC visits with non‐bacterial respiratory diagnoses. These findings suggest greater attention to the appropriateness of antibiotic prescribing in both settings and the incorporation of specific guidance on codeine products in opioid‐prescribing guidelines.
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spelling pubmed-91496522022-06-04 Antibiotic and antitussive prescribing among urgent care and emergency department visits for respiratory diagnoses in a large health system Zakharevich, Marina Kippenhan, Matthew A. Lu, Alice Courtney, D. Mark McCarthy, Danielle M. Kim, Howard S. J Am Coll Emerg Physicians Open General Medicine OBJECTIVE: Urgent care centers (UCs) commonly evaluate patients with respiratory infections, and patients increasingly prefer UCs to emergency departments (EDs) because of their customer‐centric approach. The aim of this study is to describe antibiotic and opioid prescribing among UC and ED visits with respiratory diagnoses. METHODS: This is a cross‐sectional study of visits to 7 EDs and 6 UCs in the greater Chicago area. We included visits from July 1, 2017, to June 30, 2019, with a primary diagnosis of upper or lower respiratory infection. We describe the proportion of visits resulting in an antibiotic or antitussive prescription as well as the most frequently prescribed medications in these categories. We also describe the demographic and clinical characteristics of visits. RESULTS: Of 9134 ED visits, 32.9% were prescribed an antibiotic and 14.4% an antitussive (6.6% opioid). Of 41,380 UC visits for respiratory diagnoses, 57.9% were prescribed an antibiotic and 25.0% an antitussive (9.3% opioid). The most frequently prescribed antibiotics among ED and UC visits were penicillins (36.6% and 44.5%, respectively) and macrolides (44.1% and 35.3%, respectively). The most commonly prescribed opioid was codeine (55.6% and 91.0%, respectively). Median waiting room time was 16 and 5 minutes for ED and UC visits, respectively; median length of stay was 178 and 41 minutes, respectively. CONCLUSIONS: Antibiotics and antitussives, including opioids, are frequently prescribed for ED and UC visits with non‐bacterial respiratory diagnoses. These findings suggest greater attention to the appropriateness of antibiotic prescribing in both settings and the incorporation of specific guidance on codeine products in opioid‐prescribing guidelines. John Wiley and Sons Inc. 2022-05-30 /pmc/articles/PMC9149652/ /pubmed/35662900 http://dx.doi.org/10.1002/emp2.12741 Text en © 2022 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle General Medicine
Zakharevich, Marina
Kippenhan, Matthew A.
Lu, Alice
Courtney, D. Mark
McCarthy, Danielle M.
Kim, Howard S.
Antibiotic and antitussive prescribing among urgent care and emergency department visits for respiratory diagnoses in a large health system
title Antibiotic and antitussive prescribing among urgent care and emergency department visits for respiratory diagnoses in a large health system
title_full Antibiotic and antitussive prescribing among urgent care and emergency department visits for respiratory diagnoses in a large health system
title_fullStr Antibiotic and antitussive prescribing among urgent care and emergency department visits for respiratory diagnoses in a large health system
title_full_unstemmed Antibiotic and antitussive prescribing among urgent care and emergency department visits for respiratory diagnoses in a large health system
title_short Antibiotic and antitussive prescribing among urgent care and emergency department visits for respiratory diagnoses in a large health system
title_sort antibiotic and antitussive prescribing among urgent care and emergency department visits for respiratory diagnoses in a large health system
topic General Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9149652/
https://www.ncbi.nlm.nih.gov/pubmed/35662900
http://dx.doi.org/10.1002/emp2.12741
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