title: Antibiotic prescribing by primary care physicians for children with upper respiratory tract infections.
abstract: OBJECTIVE
  To determine if the rate of appropriate antibiotic use in the treatment of children with bronchitis, viral upper respiratory tract infections, sinusitis, otitis media, and pharyngitis has changed in recent years and to identify factors that are associated with the use of inappropriate antibiotic therapy.
  
  
  METHODS
  The National Ambulatory Medical Care Survey was used to examine the antimicrobial prescribing habits of physicians who provide primary care for children. Data were analyzed from 1995-1998.
  
  
  METHODS
  Office-based physician practices.
  
  
  METHODS
  Pediatricians, family physicians, and generalists completing survey forms for patients younger than 18 years.
  
  
  METHODS
  The appropriate use of antibiotics for upper respiratory tract infections.
  
  
  RESULTS
  Multivariate analyses were used to examine factors associated with the use of inappropriate antibiotics to treat either upper respiratory tract infections or bronchitis. Patients seen in 1998 and diagnosed as having upper respiratory tract infections were 0.69 (95% confidence interval, 0.59-0.81) times less likely to be treated with antibiotics compared with patients seen in 1995. Multivariate analyses were also used to assess factors associated with the use of antibiotics with a suboptimal therapeutic profile for the treatment of either sinusitis or otitis media. Children diagnosed as having either sinusitis or otitis media were 0.3 (95% confidence interval [CI], 0.16-0.48) times less likely to receive antibiotics with a suboptimal therapeutic effect in 1998 compared with 1995.
  
  
  CONCLUSIONS
  Physicians are slowly improving their antibiotic prescribing patterns but the use of inappropriate antibiotics is still common. Almost half of patients with upper respiratory tract infections receive antibiotics.
authors.affiliation: Department of Pediatrics, University of Pittsburgh School of Medicine, PA 15213, USA. david.nash@chp.edu
authors.forename: David R
authors.initials: DR
authors.lastname: Nash
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Harman
authors.forename: Ellen R
authors.initials: ER
authors.lastname: Wald
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Kelleher
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001991:Bronchitis / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015999:Multivariate Analysis; D009819:Office Visits; D010033:Otitis Media / Q000188:drug therapy; D010612:Pharyngitis / Q000188:drug therapy; D010821:Physicians, Family; D010818:Practice Patterns, Physicians'; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D012852:Sinusitis / Q000188:drug therapy; D019564:Unnecessary Procedures
chemical_list: D000900:Anti-Bacterial Agents