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Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis.

Abstract

CONTEXT

The spread of antibiotic-resistant bacteria is associated with antibiotic use. Children receive a significant proportion of the antibiotics prescribed each year and represent an important target group for efforts aimed at reducing unnecessary antibiotic use.

OBJECTIVE

To evaluate antibiotic-prescribing practices for children younger than 18 years who had received a diagnosis of cold, upper respiratory tract infection (URI), or bronchitis in the United States.

DESIGN

Representative national survey of practicing physicians participating in the National Ambulatory Medical Care Survey conducted in 1992 with a response rate of 73%.

SETTING

Office-based physician practices.

PARTICIPANTS

Physicians completing patient record forms for patients younger than 18 years.

MAIN OUTCOME MEASURES

Principal diagnoses and antibiotic prescriptions.

RESULTS

A total of 531 pediatric office visits were recorded that included a principal diagnosis of cold, URI, or bronchitis. Antibiotics were prescribed to 44% of patients with common colds, 46% with URIs, and 75% with bronchitis. Extrapolating to the United States, 6.5 million prescriptions (12% of all prescriptions for children) were written for children diagnosed as having a URI or nasopharyngitis (common cold), and 4.7 million (9% of all prescriptions for children) were written for children diagnosed as having bronchitis. After controlling for confounding factors, antibiotics were prescribed more often for children aged 5 to 11 years than for younger children (odds ratio [OR], 1.94; 95% confidence interval [CI], 1.13-3.33) and rates were lower for pediatricians than for nonpediatricians (OR, 0.57; 95% CI, 0.35-0.92). Children aged 0 to 4 years received 53% of all antibiotic prescriptions, and otitis media was the most frequent diagnosis for which antibiotics were prescribed (30% of all prescriptions).

CONCLUSIONS

Antibiotic prescribing for children diagnosed as having colds, URIs, and bronchitis, conditions that typically do not benefit from antibiotics, represents a substantial proportion of total antibiotic prescriptions to children in the United States each year.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Pediatrics, University of Colorado Health Sciences Center, Denver 80262, USA.

    , ,

    Source

    JAMA 279:11 1998 Mar 18 pg 875-7

    MeSH

    Adolescent
    Anti-Bacterial Agents
    Bronchitis
    Child
    Child, Preschool
    Common Cold
    Drug Resistance, Microbial
    Drug Utilization
    Female
    Health Services Misuse
    Humans
    Infant
    Logistic Models
    Male
    Multivariate Analysis
    Pediatrics
    Practice Patterns, Physicians'
    Respiratory Tract Infections
    United States

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    9516004

    Citation

    Nyquist, A C., et al. "Antibiotic Prescribing for Children With Colds, Upper Respiratory Tract Infections, and Bronchitis." JAMA, vol. 279, no. 11, 1998, pp. 875-7.
    Nyquist AC, Gonzales R, Steiner JF, et al. Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis. JAMA. 1998;279(11):875-7.
    Nyquist, A. C., Gonzales, R., Steiner, J. F., & Sande, M. A. (1998). Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis. JAMA, 279(11), pp. 875-7.
    Nyquist AC, et al. Antibiotic Prescribing for Children With Colds, Upper Respiratory Tract Infections, and Bronchitis. JAMA. 1998 Mar 18;279(11):875-7. PubMed PMID: 9516004.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis. AU - Nyquist,A C, AU - Gonzales,R, AU - Steiner,J F, AU - Sande,M A, PY - 1998/3/27/pubmed PY - 2001/8/14/medline PY - 1998/3/27/entrez SP - 875 EP - 7 JF - JAMA JO - JAMA VL - 279 IS - 11 N2 - CONTEXT: The spread of antibiotic-resistant bacteria is associated with antibiotic use. Children receive a significant proportion of the antibiotics prescribed each year and represent an important target group for efforts aimed at reducing unnecessary antibiotic use. OBJECTIVE: To evaluate antibiotic-prescribing practices for children younger than 18 years who had received a diagnosis of cold, upper respiratory tract infection (URI), or bronchitis in the United States. DESIGN: Representative national survey of practicing physicians participating in the National Ambulatory Medical Care Survey conducted in 1992 with a response rate of 73%. SETTING: Office-based physician practices. PARTICIPANTS: Physicians completing patient record forms for patients younger than 18 years. MAIN OUTCOME MEASURES: Principal diagnoses and antibiotic prescriptions. RESULTS: A total of 531 pediatric office visits were recorded that included a principal diagnosis of cold, URI, or bronchitis. Antibiotics were prescribed to 44% of patients with common colds, 46% with URIs, and 75% with bronchitis. Extrapolating to the United States, 6.5 million prescriptions (12% of all prescriptions for children) were written for children diagnosed as having a URI or nasopharyngitis (common cold), and 4.7 million (9% of all prescriptions for children) were written for children diagnosed as having bronchitis. After controlling for confounding factors, antibiotics were prescribed more often for children aged 5 to 11 years than for younger children (odds ratio [OR], 1.94; 95% confidence interval [CI], 1.13-3.33) and rates were lower for pediatricians than for nonpediatricians (OR, 0.57; 95% CI, 0.35-0.92). Children aged 0 to 4 years received 53% of all antibiotic prescriptions, and otitis media was the most frequent diagnosis for which antibiotics were prescribed (30% of all prescriptions). CONCLUSIONS: Antibiotic prescribing for children diagnosed as having colds, URIs, and bronchitis, conditions that typically do not benefit from antibiotics, represents a substantial proportion of total antibiotic prescriptions to children in the United States each year. SN - 0098-7484 UR - https://www.unboundmedicine.com/medline/citation/9516004/full_citation L2 - https://jamanetwork.com/journals/jama/fullarticle/vol/279/pg/875 DB - PRIME DP - Unbound Medicine ER -