Appropriateness of Antibiotic Prescribing for Acute Sinusitis in Primary Care: A Cross-sectional Study

Truitt, Katie; Brown, Tiffany; Lee, Ji Young; Linder, Jeffrey A.

doi:10.1093/cid/ciaa736

Cited by 21 publications

(13 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Antibiotic prescribing patterns is a frequently studied healthcare quality metric given risk to patient safety with unnecessary exposure and adverse effects, 15 as well as contributing to antimicrobial resistance. 16 National rates of antibiotic prescriptions for ARS visits varies widely from 72% to 96%, 5,[17][18][19] which aligns with our findings in this study. Specifically, acute respiratory infections without a clear bacterial source are the most common cause for antibiotic prescriptions.…”

Section: Discussionsupporting

confidence: 90%

Antibiotic Prescribing for Acute Rhinosinusitis: In‐Person Versus Virtual Visits During Covid‐19

Miller

Bhattacharyya

2020

The Laryngoscope

View full text Add to dashboard Cite

Objectives/Hypothesis: Determine if antibiotic prescribing patterns differ for in-person versus virtual clinic visits for acute rhinosinusitis (ARS).Study Design: Cross sectional study. Methods: All adult virtual clinical encounters from March to May 2020 with a principal diagnosis of ARS were reviewed for demographic data and the presence or absence of an antibiotic prescription during the coronavirus shut down in Massachusetts. In-person clinical encounters from March to May 2019 were similarly examined as a control. The rate of antibiotic prescription was compared between virtual (2020) and in-person ( 2019) visits for ARS diagnoses.Results: There were 2,075 patients in March to May 2020 and 3,654 patients March to May 2019 who received an ARS principal diagnosis at their virtual and in-person outpatient visits, respectively. There was a statistically significant lower rate of antibiotic prescriptions for ARS in 2020 (72.1%) versus 2019 (76.7%).The odds ratio for an antibiotic prescription for ARS was 0.783 (95% confidence interval, 0.693-0.86; P < .001) for patients seen in the 2020 cohort versus the 2019 cohort. The compared rates for antibiotic prescribing for 2020 versus 2019 were not different in individual month-to-month comparisons. When stratified by otolaryngology providers there was no statistically significant difference of antibiotic prescriptions between the 2019 and 2020 cohort (P = .781).Conclusions: During the massive transition to virtual visits for March to May 2020 due to the coronavirus pandemic shut down in Massachusetts, the total rate of outpatient antibiotic prescribing for ARS was lower in the virtual visit environment compared to the traditional in-person visit. In this scenario, telemedicine did not result in an increase in antibiotic prescribing despite the lack of an in-person physical exam.

show abstract

Section: Discussionsupporting

confidence: 90%

Antibiotic Prescribing for Acute Rhinosinusitis: In‐Person Versus Virtual Visits During Covid‐19

Miller

Bhattacharyya

2020

The Laryngoscope

View full text Add to dashboard Cite

show abstract

“…[21][22][23] However, clinicians prescribe antibiotics for nonspecific upper respiratory tract infections, acute bronchitis, as well as pharyngitis and sinusitis that do not meet guideline criteria for antibiotic prescribing. [24][25][26] Beyond acute respiratory infections, we have conducted analyses showing that up to 50% of all antibiotics prescribed in ambulatory care in the United States are either inappropriate or not associated with a diagnosis. 10 , 19 , 27 Despite decades of admonitions and education to improve ambulatory antibiotic use, leading up to the COVID-19 pandemic in early 2020, ambulatory antibiotic prescribing had not decreased meaningfully in the United States over the prior decade and remains at about 800 prescriptions per 1000 Americans per year.…”

Section: Results and Discussion Ambulatory Antibiotic Prescribingmentioning

confidence: 99%

Behavioral Economics and Ambulatory Antibiotic Stewardship: A Narrative Review

Richards

Linder

2021

Clinical Therapeutics

Self Cite

View full text Add to dashboard Cite

“…Criteria for the appropriate prescription of antibiotics include persistent symptoms over at least 10 days, severe symptoms, and worsening symptoms. Unfortunately, there is often no difference in the proportion of antibiotic prescription between patients who meet the criteria for the prescription of antibiotics and those who do not [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Antibiotic Prescription in Patients with Acute Rhinosinusitis Treated by General Practitioners and Otolaryngologists in Germany—A Retrospective Cohort Study

et al. 2022

View full text Add to dashboard Cite

(1) Background: The goal of this retrospective cohort study, based on real-world data and conducted in Germany, was to investigate the prevalence of antibiotic (AB) prescription in patients with acute rhinosinusitis (ARS). (2) Methods: Data from the Disease Analyzer database were used for this cross-sectional study. Patients aged ≥18 years diagnosed with acute sinusitis by general practitioners (GPs) and ear, nose, throat (ENT) specialists between January 2012 and December 2020 were included. The main outcome of the study was the proportion of patients with ARS who received an AB prescription on the day of diagnosis or within three days afterwards. The proportion was estimated separately for patients treated by GPs and ENTs, and also for five age groups, as well as women and men. (3) Results: In total, 308,095 patients were diagnosed with ARS (187,838 by GPs and 120,257 by ENTs). 50.9% of patients treated by GPs and 50.0% treated by ENTs received an AB prescription. AB prevalence increased with age from 46.9% in the age group 18–30 years to 55.5% in the age group > 60 years. (4) Conclusions: We have shown a high prevalence of potentially inappropriate AB prescription for adult patients with ARS in both GP and ENT practices and also among both women and men and in several age groups. There is an urgent need for interventions to reduce inappropriate AB use.

show abstract

Appropriateness of Antibiotic Prescribing for Acute Sinusitis in Primary Care: A Cross-sectional Study

Cited by 21 publications

References 13 publications

Antibiotic Prescribing for Acute Rhinosinusitis: In‐Person Versus Virtual Visits During Covid‐19

Antibiotic Prescribing for Acute Rhinosinusitis: In‐Person Versus Virtual Visits During Covid‐19

Behavioral Economics and Ambulatory Antibiotic Stewardship: A Narrative Review

Prevalence of Antibiotic Prescription in Patients with Acute Rhinosinusitis Treated by General Practitioners and Otolaryngologists in Germany—A Retrospective Cohort Study

Contact Info

Product

Resources

About