Focus area: Physicians
Antibiotic prescribing for acute respiratory infections during influenza seasons
Acute respiratory infections (ARIs) remain the clinical category for which antibiotics are most commonly prescribed. However, most ARIs are caused by viruses for which antibiotics have no role in treatment. Inappropriate antibiotic use contributes to the development of antibiotic-resistant organisms.
Cohort study enrolling outpatients aged 6 months or older with ARI during the 2013-2014 and 2014-2015 influenza seasons. They included 14987 patients. Among these, the mean (SD) age was 32 (24) years, 8638 (58%) were women. 6% of the patients were in the age group between 0,5 and 2 years old, 10% in the age group between 2 and 5 years old, and 22% in the age group between 5 and 18 years old.
Among 14 987 patient visits analyzed, 6136 (41%) were associated with an antibiotic prescription.
Influenza was confirmed through research testing in 3381 patients (23%); among them 945 (29%) were prescribed an antibiotic, accounting for 17%of all antibiotic prescriptions among patients with nonpneumonia ARI. Laboratory-confirmed influenza was detected in 72 of 375 patients (16%) diagnosed as having pneumonia, 446 of 2065 patients (18%) with pharyngitis, 129 of 1099 patients (11%) with suppurative OM, and 227 of 1486 patients (13%) with sinusitis.
Among 6136 patients who received antibiotic prescriptions, 2522 (41%) had only diagnoses for which antibiotics are not indicated, the proportion of them increased with increasing age.
In this study antibiotics were likely prescribed inappropriately to a majority of the nearly 15 000 outpatients who presented during influenza season with symptoms of a broadly defined ARI characterized by cough.
JAMA Network Open. 2018;1(2):e180243. doi:10.1001/jamanetworkopen.2018.0243