Prescription of antibacterial agents for acute upper respiratory tract infections in Beijing, 2010-2012.

Yiqun Wu,Chao Yang,Zijun Zhou,Hanxu Xi,Yonghua Hu,Yang Zhang

doi:10.1007/s00228-015-1997-6

Abstract

PurposeThe purpose of this study was to describe the prescription of antibacterial agents for acute upper respiratory tract infections (URIs) in Beijing.MethodsA total of 8,588,699 outpatient cases in tertiary hospitals with acute upper respiratory tract infections (URIs) were selected from the Beijing Medical Claim Data for Employees (BMCDE) from Oct 2010 to Sep 2012. Second-generation cephalosporins, third-generation cephalosporins, fourth-generation cephalosporins, fluoroquinolones, macrolides (except for erythromycin), combinations of penicillins (including β-lactamase inhibitors), and streptomycins were classified as broad-spectrum antibacterial agents. The rates for antibiotic prescriptions and broad-spectrum antibiotic use were calculated in all cases as well as in various URI diagnosis subgroups and age (18–44, 45–64, and ≥65 years) subgroups. The most frequently prescribed antibiotic classes were identified by calculating the proportions of the different agents in all prescribed antibiotic agents.ResultsOverall, the rate of antibiotic prescription is 39.0 %, and cases diagnosed with acute tonsillitis, sinusitis, and epiglottitis have the highest prescription rate (73.6 %), followed by acute laryngitis and bronchitis (52.3 %), acute pharyngitis (40.1 %), and acute nasopharyngitis (37.2 %). Broad-spectrum agents were chosen in 82.4 % of the cases that were prescribed antibiotics, ranging from 81.9 % of cases with naspharyngitis to 87.1 % of the cases with tonsillitis, sinusitis, and epiglottitis. Second-generation cephalosporins, macrolides, fluoroquinolones, third-generation cephalosporins, and combinations of penicillins were most frequently prescribed, accounting for more than 80 % of all prescribed antibacterials.ConclusionsAntibacterial drug prescription for outpatients with acute URIs is common in tertiary hospitals in Beijing, and the prescribed antibacterials are usually broad-spectrum agents.Electronic supplementary materialThe online version of this article (doi:10.1007/s00228-015-1997-6) contains supplementary material, which is available to authorized users.

Highlights

Acute upper respiratory tract infections (URIs) are the most common infectious illnesses in the general population, and they are the leading cause of missed days at work or school
Substantial research suggests that antibiotics probably provide little benefit for a large proportion of respiratory tract infections, the results of this study show that nearly 40 % of outpatients with acute URIs received antibacterial drug prescriptions in tertiary hospitals in Beijing
Antibacterial drug prescriptions are common in tertiary hospitals in Beijing for cases with acute URIs, which is similar to results in the USA [13, 16] and some European countries [17]

Summary

Introduction

Acute upper respiratory tract infections (URIs) are the most common infectious illnesses in the general population, and they are the leading cause of missed days at work or school. They represent the most frequent acute diagnosis in the office setting [1]. URIs are largely self-limiting, and the majority of these infections are viral and have no cure [2]. The available evidence has shown that antibiotics probably provide little benefit for a large proportion of respiratory tract infections, antibiotics are still largely inappropriately used in clinics [3].

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