What are the patient, provider & practice characteristics associated with inappropriate antibiotic prescribing in outpatient settings? 5 notes

Patient, provider and practice characteristics are associated with inappropriate antibiotic prescriptions in ambulatory practices, according to a study in Infection Control & Hospital Epidemiology.

 Here is what you need to know:

1. This retrospective cohort study collected data from outpatient visits for upper respiratory infections that should not require antibiotics. Carolinas HealthCare System urgent care, internal medicine, family medicine and pediatric practices were included across 898 providers and 246 practices.

2. The cohort included 448,990 visits between January 2014 and May 2016 and prescribing rates were reported per 1,000 visits. The overall prescribing rate was 407 per 1,000 visits.

3. After adjustment, adult patients seen by an advanced practice provider were 15 percent more likely to receive an antimicrobial than those seen by a physician provider.

4. Among the pediatric sample, older providers were four times as likely to prescribe an antimicrobial than providers aged 30 or younger.

5. The authors suggest antibiotic stewardship programs should be targeted to specific patient and provider populations to reduce inappropriate antibiotic prescription instead of a "one size fits all" approach.

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