Abstract
To determine patterns and predictors of antimicrobial drug use for outpatients with community-acquired pneumonia, we examined office visit and pharmacy claims data of 4 large third-party payer organizations from 2000 to 2002. After patients with coexisting conditions were excluded, 4,538 patients were studied. Despite lack of coexisting conditions, fluoroquinolone use was commonly observed and increased significantly (p < 0.001) from 2000 to 2002 (24%-39%), while macrolide use decreased (55%-44%). Increased age correlated with increased fluoroquinolone use: 18-44 years (22%), 45-64 years (33%), and > or =65 years (40%) (p < 0.001). Increased use of fluoroquinolones occurred in healthy young and old patients alike, which suggests a lack of selectivity in reserving fluoroquinolones for higher risk patients. Clear and consistent guidelines are needed to address the role of fluoroquinolones in treatment of outpatient community-acquired pneumonia.
Highlights
To determine patterns and predictors of antimicrobial drug use for outpatients with community-acquired pneumonia, we examined office visit and pharmacy claims data of 4 large third-party payer organizations from 2000 to 2002
Concerns for infection due to drugresistant Streptococcus pneumoniae (DRSP) may drive fluoroquinolone use because providers fear that traditional Community-acquired pneumonia (CAP) regimens will fail [3,4]
Use of fluoroquinolones increased from 25% of all prescriptions in 2000 to 39% in 2002 (p < 0.001)
Summary
To determine patterns and predictors of antimicrobial drug use for outpatients with community-acquired pneumonia, we examined office visit and pharmacy claims data of 4 large third-party payer organizations from 2000 to 2002. Community-acquired pneumonia (CAP) is a leading cause of death due to infection in the United States and a primary indication for antimicrobial drug use in inpatient and outpatient settings. Drug Prescribing for Pneumonia in Ambulatory Care whereas fluoroquinolones are an option for the other groups [22] Such extensive subclassification and conflict among guidelines may pose difficulties for clinicians practicing in busy outpatient settings [23]. Our objective was to determine the patterns of antimicrobial drug prescribing, especially fluoroquinolone use, in a group of outpatients with CAP without serious underlying conditions
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