The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.
Antibiotic prescribing for adults in ambulatory care in the USA, 2007–09
Open accessAbstract
OBJECTIVES: To determine patterns of ambulatory antibiotic prescribing in US adults, including the use of broad-spectrum versus narrow-spectrum agents, to provide a description of the diagnoses for which antibiotics are prescribed and to identify patient and physician factors associated with broad-spectrum antibiotic prescribing. METHODS: We used data for patients aged ≥ 18 years from the National Ambulatory and National Hospital Ambulatory Medical Care Surveys (2007-09). These are nationally representative surveys of patient visits to offices, hospital outpatient departments and emergency departments (EDs) in the USA, collectively referred to as ambulatory visits. We determined the types of antibiotics prescribed, including the use of broad-spectrum versus narrow-spectrum antibiotics, and examined prescribing patterns by diagnoses. We used multivariable logistic regression to identify factors associated with broad-spectrum antibiotic prescribing. RESULTS: Antibiotics were prescribed during 101 million (95% CI: 91-111 million) ambulatory visits annually, representing 10% of all visits. Broad-spectrum agents were prescribed during 61% of visits in which antibiotics were prescribed. The most commonly prescribed antibiotics were quinolones (25% of antibiotics), macrolides (20%) and aminopenicillins (12%). Antibiotics were most commonly prescribed for respiratory conditions (41% of antibiotics), skin/mucosal conditions (18%) and urinary tract infections (9%). In multivariable analysis, among patients prescribed antibiotics, broad-spectrum agents were more likely to be prescribed than narrow-spectrum antibiotics for respiratory infections for which antibiotics are rarely indicated (e.g. bronchitis), during visits to EDs and for patients ≥ 60 years. CONCLUSIONS: Broad-spectrum agents constitute the majority of antibiotics in ambulatory care. More than 25% of prescriptions are for conditions for which antibiotics are rarely indicated. Antibiotic stewardship interventions targeting respiratory and non-respiratory conditions are needed in ambulatory care.
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Liu, C., Bayer, A., Cosgrove, S. E., Daum, R. S., Fridkin, S. K., Gorwitz, R. J., Kaplan, S. L., Karchmer, A. W., Levine, D. P., Murray, B. E., et al. (2011) · Clinical Infectious Diseases · doi:10.1093/cid/ciq146 · Cited by 4,191
Gupta, K., Hooton, T. M., Naber, K. G., Wullt, B., Colgan, R., Miller, L. G., Moran, G. J., Nicolle, L. E., Raz, R., Schaeffer, A. J., et al. (2011) · Clinical Infectious Diseases · doi:10.1093/cid/ciq257 · Cited by 3,038
Methicillin-Resistant S. aureus Infections among Patients in the Emergency Department
Moran, G. J., Krishnadasan, A., Gorwitz, R. J., Fosheim, G. E., McDougal, L. K., Carey, R. B., & Talan, D. A. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa055356 · Cited by 2,285
Costelloe, C., Metcalfe, C., Lovering, A., Mant, D., & Hay, A. D. (2010) · BMJ · doi:10.1136/bmj.c2096 · Cited by 1,981
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Malhotra-Kumar, S., Lammens, C., Coenen, S., Van Herck, K., & Goossens, H. (2007) · The Lancet · doi:10.1016/s0140-6736(07)60235-9 · Cited by 545
Emergency Department Visits for Antibiotic‐Associated Adverse Events
Shehab, N., Patel, P. R., Srinivasan, A., & Budnitz, D. S. (2008) · Clinical Infectious Diseases · doi:10.1086/591126 · Cited by 535
Antibiotic Prescription Rates for Acute Respiratory Tract Infections in US Ambulatory Settings
Grijalva, C. G. (2009) · JAMA · doi:10.1001/jama.2009.1163 · Cited by 513
Antibiotic Prescribing in Ambulatory Pediatrics in the United States
Hersh, A. L., Shapiro, D. J., Pavia, A. T., & Shah, S. S. (2011) · Pediatrics · doi:10.1542/peds.2011-1337 · Cited by 507
Self-citationGerber, J. S., Prasad, P. A., Fiks, A. G., Localio, A. R., Grundmeier, R. W., Bell, L. M., Wasserman, R. C., Keren, R., & Zaoutis, T. E. (2013) · JAMA · doi:10.1001/jama.2013.6287 · Cited by 404
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Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011
Fleming-Dutra, K. E., Hersh, A. L., Shapiro, D. J., Bartoces, M., Enns, E. A., File, T. M., Finkelstein, J. A., Gerber, J. S., Hyun, D. Y., Linder, J. A., et al. (2016) · JAMA · doi:10.1001/jama.2016.4151 · Cited by 1,740
Self-citationEvaluation and Management of Penicillin Allergy: A Review
Shenoy, E. S., Macy, E., Rowe, T., & Blumenthal, K. G. (2019) · JAMA · doi:10.1001/jama.2018.19283 · Cited by 830
Core elements of outpatient antibiotic stewardship.
Sanchez, G. V., Fleming-Dutra, K. E., Roberts, R. M., & Hicks, L. A. (2016) · MMWR. Recommendations and Reports · doi:10.15585/mmwr.rr6506a1 · Cited by 607
Self-citationHicks, L. A., Bartoces, M. G., Roberts, R. M., Suda, K. J., Hunkler, R. J., Taylor, T. H., & Schrag, S. J. (2015) · Clinical Infectious Diseases · doi:10.1093/cid/civ076 · Cited by 559
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Metadata
- Authors
- Shapiro, D. J., Hicks, L. A., Pavia, A. T., & Hersh, A. L.
- Venue
- Journal of Antimicrobial Chemotherapy
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-07-25
- Volume
- 69
- Issue
- 1
- Pages
- 234-240
- ISSN
- 0305-7453 (ISSN-L)
- 1460-2091
- OpenAlex
- W2157021248
- Cited by
- 466
- References
- 30
- FWCI
- 22.16
- Type
- journal article
- Language
- en
- Open access
- bronze
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