Tamar F. Barlam|Rene Soria-Saucedo|Howard Cabral|Lewis E. Kazis
Unnecessary Antibiotics for Acute Respiratory Tract Infections: Association With Care Setting and Patient Demographics
Office of Infectious Diseases|Center for Assessment|Boston University|Center for Assessment
background 40 antibiotics prescribed unnecessarily acute respiratory tract infections artis sought define factors associated antibiotic overprescribing artis inform efforts improve practice methods conducted retrospective analysis arti visits 2006 2010 national ambulatory medical care survey national hospital ambulatory medical care survey surveys provide representative sample us visits communitybased physicians hospitalbased emergency departments eds outpatient practices patient factors age sex race underlying lung disease tobacco use insurance physician specialty practice demographics percentage poverty median household income percentage bachelors degree urbanrural status geographic region care setting ed hospital communitybased practice evaluated predictors antibiotic overprescribing artis results hospital communitypractice visits antibiotic overprescribing ed visits odds ratio 164 95 confidence interval ci 127212 159 95 ci 126201 respectively care setting significant interactions geographic region urban rural location quartile lowest percentage collegeeducated residents significantly greater overprescribing adjusted 141 95 ci 107186 highest quartile current tobacco users overprescribed often nonsmokers 171 95 ci 138212 patient age insurance provider specialty significant predictors conclusions tobacco use lower grouped rate college education associated overprescribing may reflect poor health literacy focus educating patient may effective approach stewardship