Antibiotic Prescribing Practices

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Contents

Introduction

Epidemiology

Management

Notes

  • patient beliefs & expectations are part of the problem
  • > 1/2 of healthcare providers believe patients expect antibiotics during a visit for a viral infection, whereas only ~1/4 of patients actually expect them [12]
  • hispanics more likely other patients to expect antibiotics (41% vs 26%) [12]
  • ~1/2 of hispanic patients & 20% of all patients obtain antibiotics from a source other than their doctor or clinic, most often grocery stores, friends & family, or leftovers from a previous prescription [12]
  • overall, useof 1st-line agents was 52% [16]
  • consider the cost to benefit: [3]
  • prescribing practices may be changed by simple measures

Additional Terms

References

  1. Journal Watch 24(19):153, 2004 Welschen I, Kuyvenhoven MM, Hoes AW, Verheij TJ. Effectiveness of a multiple intervention to reduce antibiotic prescribing for respiratory tract symptoms in primary care: randomised controlled trial. BMJ. 2004 Aug 21;329(7463):431. Epub 2004 Aug 05. <PubMed> PMID: [1] <Internet> [2]
  2. Coca A & Mainous AG Relation of time spent in an encounter with the use of antibiotics in pediatric office visits for viral respiratory infections Arch Pedriatr Adolesc Med 2005; 159:1145 PMID: [3]
  3. Prescriber's Letter 15(10): 2008 COMMENTARY: Antibiotic Overuse POSTER: Cold or Flu. Antibiotics Don't Work for You Handout: Cold or Flu. Antibiotics Don't Work for You Detail-Document#: [4] (subscription needed) [5]
  4. Costelloe C et al. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: Systematic review and meta-analysis. BMJ 2010 May 18; 340:c2096 PMID: [6]
  5. Physician's First Watch, Oct 10, 2012 Massachusetts Medical Society [7]
    - Study Succeeds in Cutting Inappropriate Antibiotic Prescribing by Pediatricians: Findings Among the Research Featured at First IDWeek Conference [8]
    - Hersh AL et al. Antibiotic prescribing in ambulatory pediatrics in the United States. Pediatrics 2011 Dec; 128:1053. PMID: [9]
  6. Kronman MP et al. Antibiotic exposure and IBD development among children: A population-based cohort study. Pediatrics 2012 Oct; 130:e794 PMID: [10]
  7. Tice AD, Rehm SJ, Dalovisio JR, Bradley JS et al Practice guidelines for outpatient parenteral antimicrobial therapy. IDSA guidelines. Clin Infect Dis. 2004 Jun 15;38(12):1651-72 PMID: [11]
  8. Barnett ML and Linder JA. Antibiotic prescribing to adults with sore throat in the United States, 1997-2010. JAMA Intern Med 2013 Oct 3 PMID: [12] JAMA Intern Med. Published online October 03, 2013
  9. Orciari Herman A, Fairchild DG, Hefner JE Tired Clinicians = More Antibiotic Prescribing? Physician's First Watch, Oct 7, 2014 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society [13]
    - Linder JA et al Time of Day and the Decision to Prescribe Antibiotics. JAMA Intern Med. Published online October 06, 2014 <PubMed> PMID: [14] <Internet> [15]
  10. Gerber JS et al Durability of Benefits of an Outpatient Antimicrobial Stewardship Intervention After Discontinuation of Audit and Feedback. JAMA. Published online October 10, 2014 <PubMed> PMID: [16] <Internet> [17]
  11. Hicks LA et al. US outpatient antibiotic prescribing variation according to geography, patient population, and provider specialty in 2011. Clin Infect Dis 2015 May 1; 60:1308 PMID: [18]
  12. Francois Watkins LK, Sanchez GV, Albert AP et al Knowledge and Attitudes Regarding Antibiotic Use Among Adult Consumers, Adult Hispanic Consumers, and Health Care Providers
    - United States, 2012-2013. MMWR. Weekly. July 24, 2015 / 64(28);767-770 [19]
  13. Jones BE et al. Variation in outpatient antibiotic prescribing for acute respiratory infections in the veteran population: A cross- sectional study. Ann Intern Med 2015 Jul 21; 163:73 PMID: [20]
  14. Hallsworth M et al. Provision of social norm feedback to high prescribers of antibiotics in general practice: A pragmatic national randomised controlled trial. Lancet 2016 Feb 18 PMID: [21]
  15. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
  16. Hersh AL et al. Frequency of first-line antibiotic selection among US ambulatory care visits for otitis media, sinusitis, and pharyngitis. JAMA Intern Med 2016 Oct 24 PMID: [22]
  17. Meeker D, Linder JA, Fox CR et al Effects of Behavioral Interventions on Inappropriate Antibiotic Prescribing in Primary Care 12 Months After Stopping Interventions. JAMA. 2017;318(14):1391-1392 PMID: [23] [24]
    - Linder JA, Meeker D, Fox CR et al Effects of Behavioral Interventions on Inappropriate Antibiotic Prescribing in Primary Care 12 Months After Stopping Interventions. JAMA. 2017 Oct 10;318(14):1391-1392. PMID: [25]

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