Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Trends in antibiotic prescribing for adults in the United States—1995 to 2002

Trends in antibiotic prescribing for adults in the United States—1995 to 2002 CONTEXT: The impact of national efforts to limit antibiotic prescribing has not been fully evaluated.OBJECTIVES: To analyze trends in outpatient visits associated with antibiotic prescription for U.S. adults.DESIGN: Cross-sectional study of data (1995 to 2002) from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey.PARTICIPANTS: Adults ≥18 years with an outpatient visit to an office-or hospital-based medical practice or to an emergency department. All visits were classified into 1 of 4 diagnostic categories: (1) acute respiratory infection (ARI)—antibiotics rarely indicated, (2) ARI—antibiotics often indicated, (3) nonrespiratory infection—antibiotics often indicated, and (4) all others.MEASUREMENTS: Trends in: (1) Proportion of outpatient visits associated with an antibiotic prescription; (2) proportion of antibiotic prescriptions that were broad spectrum; and (3) number of visits and antibiotic prescriptions per 1,000 U.S. adults ≥18 years of age.RESULTS: From 1995–1996 to 2001–2002, the proportion of all outpatient visits that generated an antibiotic prescription decreased from 17.9% to 15.3% (adjusted odds ratio [OR] 0.84, 95% confidence interval [CI] 0.76 to 0.92). The entire reduction was because of a decrease in antibiotic prescriptions associated with visits for ARIs where antibiotics are rarely indicated from 59.9% to 49.1% (adjusted OR 0.64 95% CI 0.51 to 0.80). However, the proportion of prescribed antibiotics for these visits that were classified as broad-spectrum antibiotic prescription increased from 41.0% to 76.8%. Overall outpatient visits increased from 1693 to 1986 per 1,000 adults over the 8 years studied, but associated antibiotic prescriptions changed little, from 302 to 304 per 1,000 adults.CONCLUSION: During the study period, outpatient antibiotic prescribing for respiratory infections where antibiotics are rarely indicated has declined, while the proportion of broad-spectrum antibiotics prescribed for these diagnoses has increased significantly. This trend resulted in a 15% decline in the total proportion of outpatient visits in which antibiotics were prescribed. However, because outpatient visits increased 17% over this time period, the population burden of outpatient antibiotic prescriptions changed little. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of General Internal Medicine Springer Journals

Loading next page...
 
/lp/springer-journals/trends-in-antibiotic-prescribing-for-adults-in-the-united-states-1995-sAbRAlO0eF

References (37)

Publisher
Springer Journals
Copyright
Copyright © Society of General Internal Medicine 2005
Subject
Medicine & Public Health; Internal Medicine
ISSN
0884-8734
eISSN
1525-1497
DOI
10.1111/j.1525-1497.2005.0148.x
pmid
16050877
Publisher site
See Article on Publisher Site

Abstract

CONTEXT: The impact of national efforts to limit antibiotic prescribing has not been fully evaluated.OBJECTIVES: To analyze trends in outpatient visits associated with antibiotic prescription for U.S. adults.DESIGN: Cross-sectional study of data (1995 to 2002) from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey.PARTICIPANTS: Adults ≥18 years with an outpatient visit to an office-or hospital-based medical practice or to an emergency department. All visits were classified into 1 of 4 diagnostic categories: (1) acute respiratory infection (ARI)—antibiotics rarely indicated, (2) ARI—antibiotics often indicated, (3) nonrespiratory infection—antibiotics often indicated, and (4) all others.MEASUREMENTS: Trends in: (1) Proportion of outpatient visits associated with an antibiotic prescription; (2) proportion of antibiotic prescriptions that were broad spectrum; and (3) number of visits and antibiotic prescriptions per 1,000 U.S. adults ≥18 years of age.RESULTS: From 1995–1996 to 2001–2002, the proportion of all outpatient visits that generated an antibiotic prescription decreased from 17.9% to 15.3% (adjusted odds ratio [OR] 0.84, 95% confidence interval [CI] 0.76 to 0.92). The entire reduction was because of a decrease in antibiotic prescriptions associated with visits for ARIs where antibiotics are rarely indicated from 59.9% to 49.1% (adjusted OR 0.64 95% CI 0.51 to 0.80). However, the proportion of prescribed antibiotics for these visits that were classified as broad-spectrum antibiotic prescription increased from 41.0% to 76.8%. Overall outpatient visits increased from 1693 to 1986 per 1,000 adults over the 8 years studied, but associated antibiotic prescriptions changed little, from 302 to 304 per 1,000 adults.CONCLUSION: During the study period, outpatient antibiotic prescribing for respiratory infections where antibiotics are rarely indicated has declined, while the proportion of broad-spectrum antibiotics prescribed for these diagnoses has increased significantly. This trend resulted in a 15% decline in the total proportion of outpatient visits in which antibiotics were prescribed. However, because outpatient visits increased 17% over this time period, the population burden of outpatient antibiotic prescriptions changed little.

Journal

Journal of General Internal MedicineSpringer Journals

Published: Aug 1, 2005

Keywords: antibiotics; prescribing; United States; NAMCS; NHAMCS

There are no references for this article.