Background: Inappropriate antibiotic use promotes resistance. Antibiotics are generally not indicated for upper respiratory infections(URIs). Our objectives were to describe URI treatment patterns and estimate the predictive power of comorbidities for antibiotics in URIs. Methods: Using administrative claims, we identified Pennsylvania Medicaid recipients with a URI office visit. Our outcome variable was antibiotic use(AB) within seven days after the URI. Our predictor variables were concurrent acute illnesses (otitis, streptococcal pharyngitis, pneumonia, chronic sinusitis, acute sinusitis, UTI, bacteremia), chronic conditions (chronic bronchitis, immunodeficiency, transplant, malignancy), demographics, season, physician specialty, type and number of URI). We considered the independent effects of each of the predictors of AB in a multivariate logistic regression model. Since age modified the effect between AB and several predictors, we report separate models for four age groups. Results: Among 69,936 recipients with URI, 35,786(51.2%) received an antibiotic. In all age groups, acute sinusitis, chronic sinusitis, otitis, geographic residence, URI type and season were associated with AB. Except for the oldest group, race, physician specialty, and streptococcal pharyngitis were associated with AB. Number of URIs per year and chronic conditions were not associated with AB in any age group. Explained variance ranged from 4.37%(22 to 44 year group) to 13.08%(0 to 5 year group). Discussion: Prevalence of antibiotic use for URIs was high, indicating that potentially inappropriate antibiotic utilization is likely occurring. Our data suggest that demographic and clinical factors are associated with antibiotic use, but additional reasons for these decisions remain unexplained.
Learning Objectives: At the conclusion of this presentation, the listener will be able to: (1) Recognize the importance of judicious antibiotic use; (2) Identify factors associated with antibiotic use for upper respiratory tract infections.
Keywords: Antibiotic Resistance, Drug Use
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.