Abstract
Reducing inappropriate antibiotic prescribing is currently a global health priority. Current guidelines recommend against antibiotic treatment for acute uncomplicated bronchitis. We studied antibiotic prescribing patterns for uncomplicated acute bronchitis and identified predictors of inappropriate antibiotic prescribing. We used the Epic Clarity database (electronic medical record system) to identify all adult patients with acute bronchitis in family medicine clinics from 2011 to 2016. We excluded factors that could justify antibiotic use, such as suspected pneumonia, COPD or immunocompromising conditions. Of the 3616 visits for uncomplicated acute bronchitis, 2244 (62.1%) resulted in antibiotic treatment. The rates of antibiotic prescribing were similar across the years, p value for trend = 0.07. Antibiotics were most frequently prescribed in the age group of 18–39 years (66.9%), followed by the age group of 65 years and above (59.0%), and the age group of 40–64 years (58.7%), p value < 0.001. Macrolides were significantly more likely to be prescribed for younger adults, while fluoroquinolones were more likely to be prescribed for patients 65 years or older. Duration of antibiotic use was significantly longer in older adults. Sex and race were not associated with antibiotic prescribing. Our findings highlight the urgent need to reduce inappropriate antibiotic use for uncomplicated acute bronchitis, particularly in younger adults.
Highlights
Reducing inappropriate antibiotic prescribing is currently a global health priority
Most of the visits for uncomplicated acute bronchitis were made by the age group 40–64 years (Table 1)
Antibiotics were commonly prescribed for uncomplicated acute bronchitis in patients visiting family medicine clinics, despite evidence-based guidelines recommending against this practice [5,6]
Summary
Reducing inappropriate antibiotic prescribing is currently a global health priority. The 2015. Physicians, antibiotic treatment is not indicated for uncomplicated acute bronchitis [5,6]. Previous studies indicated that 65–71% of acute bronchitis visits have inappropriately resulted in antibiotic prescriptions [8,9]. These previous studies used survey data to estimate the burden of inappropriate antibiotic use between the years of 1996–2010 [8] and. Our study adds to the previous literature by studying more recent antibiotic prescribing patterns for uncomplicated acute bronchitis using electronic medical records data from 2011 to 2016, and by excluding factors that could justify antibiotic use such as suspected pneumonia We explored the duration and type of antibiotics inappropriately prescribed in primary care settings as well as the relationship between patient characteristics and antibiotic prescribing for acute bronchitis
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