National Trends in Visit Rates and Antibiotic Prescribing for Children With Acute Sinusitis
Open accessAbstract
OBJECTIVE: The heptavalent pneumococcal conjugate vaccine contributed to a substantial decrease in the number of ambulatory visits attributable to acute otitis media (AOM) and amoxicillin use for AOM increased after publication of American Academy of Pediatrics guidelines regarding AOM. Our objective was to determine whether similar trends occurred for children with acute sinusitis. METHODS: We analyzed data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey (1998–2007), which are nationally representative surveys of office and emergency department visits. For children younger than 18 years with diagnosed acute sinusitis (N = 538), we examined time trends in visit rates and antibiotic prescribing. Multivariate logistic regression analyses were used to identify factors associated with narrow-spectrum antibiotic prescribing. RESULTS: Between 1998 and 2007, the annual visit rate for acute sinusitis remained stable, ranging from 11 to 14 visits per 1000 children (P = .67). No change occurred in the proportion of visits with receipt of an antibiotic (82%; P = .71); however, the proportion with receipt of amoxicillin increased from 19% to 58% during the study period (P < .01). Prescriptions for broader-spectrum agents, especially macrolides (18% overall), remained common. CONCLUSIONS: Unlike the visit rate for AOM, the visit rate for acute sinusitis among children did not decrease after introduction of the pneumococcal conjugate vaccine. Although prescriptions for amoxicillin increased in accordance with the guidelines, reducing unnecessary prescriptions for macrolides remains an important target for campaigns promoting judicious antibiotic use.
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RARS is defined as at least 4 episodes of ARS per year, with disease-free intervals between episodes.
“RARS is defined as at least 4 episodes of ARS per year, with disease-free intervals between episodes.1,137,138,266,268”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [268]
The ‘Visits Attributable to Acute Sinusitis’ section (page unavailable) defines visits using an acute-sinusitis diagnosis code and reports annual visit rates, not a definition of recurrent acute rhinosinusitis. Searches for RARS, four episodes per year, and disease-free intervals found no passage addressing that definition. (LLM, conf=0.76)
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- Authors
- Shapiro, D. J., Gonzales, R., Cabana, M. D., & Hersh, A. L.
- Affiliations
- Philip R. Lee Institute for Health Policy Studies (US)
- University of California, San Francisco (US)
- Corresponding author
- Hersh, Adam L.
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2011-01-01
- Volume
- 127
- Issue
- 1
- Pages
- 28-34
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC3010093
- OpenAlex
- W1987524180
- Cited by
- 66
- References
- 25
- Citations by year
- 2025: 5 · 2024: 3 · 2023: 4 · 2022: 3 · 2021: 3 · 2020: 4 · 2019: 5 · 2018: 3 · 2017: 4 · 2016: 5 · 2015: 2 · 2014: 8 · 2013: 11 · 2012: 5
- FWCI
- 7.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- PEDIATRICS (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Center for Research Resources (KL2 RR02413)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (T32HD044331)
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Keywords
- acute sinusitis, children, antibiotic prescribing, amoxicillin, macrolides, broad-spectrum antibiotics, narrow-spectrum antibiotics, outpatient visits, temporal trends, pneumococcal conjugate vaccine, antibiotic stewardship, guideline adherence
- MeSH terms
- Acute Disease, Anti-Bacterial Agents, Child, Preschool, Emergency Service, Hospital, Female, Humans, Infant, Male, Office Visits, Drug Prescriptions, Sinusitis, United States
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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