Decline in Inappropriate Antibiotic Use Over a Decade by Pediatricians in a Tennessee Community

Sandra Arnold, Andrew J. Bush

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective: Published data indicates that antibiotic use for pediatric respiratory tract infections has declined across the United States. We reviewed antibiotic use in 2 pediatrics practices in Memphis, Tennessee, to determine whether there has been a reduction in inappropriate antibiotic use in this region. Methods: Randomly selected charts in 7 offices of 2 practices were reviewed for respiratory tract infection visits during alternate years between 1992 and 2002. Antibiotics were considered inappropriate for viral respiratory tract and other viral syndromes, asthma, allergic rhinitis, and otitis media with effusion. Changes in inappropriate prescribing were evaluated by generalized estimating equations with year of visit as the explanatory variable and visits clustered by practice. Results: There were 1504 unique patient visits reviewed. The number of visits with an antibiotic prescription fell from 85% in 1992 to 67% in 2002. The likelihood of inappropriately prescribing an antibiotic declined between 1992 and 2002 (odds ratio 0.28, 95% confidence interval 0.20-0.38). Use of amoxicillin-clavulanic acid and azithromycin increased, and amoxicillin use decreased. Conclusions: There has been a marked decline in inappropriate antibiotic use in this region with high prescribing rates. Pediatricians have increased their use of broad-spectrum antibiotic agents for respiratory tract infections. Continuing education of physicians regarding appropriate use should continue to maintain and improve on the gains achieved in the last decade.

Original languageEnglish (US)
Pages (from-to)225-229
Number of pages5
JournalAmbulatory Pediatrics
Volume6
Issue number4
DOIs
StatePublished - Jul 1 2006

Fingerprint

Anti-Bacterial Agents
Respiratory Tract Infections
Inappropriate Prescribing
Pediatrics
Amoxicillin-Potassium Clavulanate Combination
Otitis Media with Effusion
Azithromycin
Pediatricians
Continuing Education
Amoxicillin
Respiratory System
Prescriptions
Asthma
Odds Ratio
Confidence Intervals
Physicians

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Decline in Inappropriate Antibiotic Use Over a Decade by Pediatricians in a Tennessee Community. / Arnold, Sandra; Bush, Andrew J.

In: Ambulatory Pediatrics, Vol. 6, No. 4, 01.07.2006, p. 225-229.

Research output: Contribution to journalArticle

@article{683721b627554e319212ba41d714f2db,
title = "Decline in Inappropriate Antibiotic Use Over a Decade by Pediatricians in a Tennessee Community",
abstract = "Objective: Published data indicates that antibiotic use for pediatric respiratory tract infections has declined across the United States. We reviewed antibiotic use in 2 pediatrics practices in Memphis, Tennessee, to determine whether there has been a reduction in inappropriate antibiotic use in this region. Methods: Randomly selected charts in 7 offices of 2 practices were reviewed for respiratory tract infection visits during alternate years between 1992 and 2002. Antibiotics were considered inappropriate for viral respiratory tract and other viral syndromes, asthma, allergic rhinitis, and otitis media with effusion. Changes in inappropriate prescribing were evaluated by generalized estimating equations with year of visit as the explanatory variable and visits clustered by practice. Results: There were 1504 unique patient visits reviewed. The number of visits with an antibiotic prescription fell from 85{\%} in 1992 to 67{\%} in 2002. The likelihood of inappropriately prescribing an antibiotic declined between 1992 and 2002 (odds ratio 0.28, 95{\%} confidence interval 0.20-0.38). Use of amoxicillin-clavulanic acid and azithromycin increased, and amoxicillin use decreased. Conclusions: There has been a marked decline in inappropriate antibiotic use in this region with high prescribing rates. Pediatricians have increased their use of broad-spectrum antibiotic agents for respiratory tract infections. Continuing education of physicians regarding appropriate use should continue to maintain and improve on the gains achieved in the last decade.",
author = "Sandra Arnold and Bush, {Andrew J.}",
year = "2006",
month = "7",
day = "1",
doi = "10.1016/j.ambp.2006.04.005",
language = "English (US)",
volume = "6",
pages = "225--229",
journal = "Academic Pediatrics",
issn = "1876-2859",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Decline in Inappropriate Antibiotic Use Over a Decade by Pediatricians in a Tennessee Community

AU - Arnold, Sandra

AU - Bush, Andrew J.

PY - 2006/7/1

Y1 - 2006/7/1

N2 - Objective: Published data indicates that antibiotic use for pediatric respiratory tract infections has declined across the United States. We reviewed antibiotic use in 2 pediatrics practices in Memphis, Tennessee, to determine whether there has been a reduction in inappropriate antibiotic use in this region. Methods: Randomly selected charts in 7 offices of 2 practices were reviewed for respiratory tract infection visits during alternate years between 1992 and 2002. Antibiotics were considered inappropriate for viral respiratory tract and other viral syndromes, asthma, allergic rhinitis, and otitis media with effusion. Changes in inappropriate prescribing were evaluated by generalized estimating equations with year of visit as the explanatory variable and visits clustered by practice. Results: There were 1504 unique patient visits reviewed. The number of visits with an antibiotic prescription fell from 85% in 1992 to 67% in 2002. The likelihood of inappropriately prescribing an antibiotic declined between 1992 and 2002 (odds ratio 0.28, 95% confidence interval 0.20-0.38). Use of amoxicillin-clavulanic acid and azithromycin increased, and amoxicillin use decreased. Conclusions: There has been a marked decline in inappropriate antibiotic use in this region with high prescribing rates. Pediatricians have increased their use of broad-spectrum antibiotic agents for respiratory tract infections. Continuing education of physicians regarding appropriate use should continue to maintain and improve on the gains achieved in the last decade.

AB - Objective: Published data indicates that antibiotic use for pediatric respiratory tract infections has declined across the United States. We reviewed antibiotic use in 2 pediatrics practices in Memphis, Tennessee, to determine whether there has been a reduction in inappropriate antibiotic use in this region. Methods: Randomly selected charts in 7 offices of 2 practices were reviewed for respiratory tract infection visits during alternate years between 1992 and 2002. Antibiotics were considered inappropriate for viral respiratory tract and other viral syndromes, asthma, allergic rhinitis, and otitis media with effusion. Changes in inappropriate prescribing were evaluated by generalized estimating equations with year of visit as the explanatory variable and visits clustered by practice. Results: There were 1504 unique patient visits reviewed. The number of visits with an antibiotic prescription fell from 85% in 1992 to 67% in 2002. The likelihood of inappropriately prescribing an antibiotic declined between 1992 and 2002 (odds ratio 0.28, 95% confidence interval 0.20-0.38). Use of amoxicillin-clavulanic acid and azithromycin increased, and amoxicillin use decreased. Conclusions: There has been a marked decline in inappropriate antibiotic use in this region with high prescribing rates. Pediatricians have increased their use of broad-spectrum antibiotic agents for respiratory tract infections. Continuing education of physicians regarding appropriate use should continue to maintain and improve on the gains achieved in the last decade.

UR - http://www.scopus.com/inward/record.url?scp=33745699842&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33745699842&partnerID=8YFLogxK

U2 - 10.1016/j.ambp.2006.04.005

DO - 10.1016/j.ambp.2006.04.005

M3 - Article

VL - 6

SP - 225

EP - 229

JO - Academic Pediatrics

JF - Academic Pediatrics

SN - 1876-2859

IS - 4

ER -