title: Antimicrobial drug prescribing for pneumonia in ambulatory care.
abstract: To determine patterns and predictors of antimicrobial drug use for outpatients with community-acquired pneumonia, we examined office visit and pharmacy claims data of 4 large third-party payer organizations from 2000 to 2002. After patients with coexisting conditions were excluded, 4,538 patients were studied. Despite lack of coexisting conditions, fluoroquinolone use was commonly observed and increased significantly (p < 0.001) from 2000 to 2002 (24%-39%), while macrolide use decreased (55%-44%). Increased age correlated with increased fluoroquinolone use: 18-44 years (22%), 45-64 years (33%), and > or =65 years (40%) (p < 0.001). Increased use of fluoroquinolones occurred in healthy young and old patients alike, which suggests a lack of selectivity in reserving fluoroquinolones for higher risk patients. Clear and consistent guidelines are needed to address the role of fluoroquinolones in treatment of outpatient community-acquired pneumonia.
authors.affiliation: University of California School of Pharmacy, San Francisco, California, USA. cmac@vcu.edu
authors.forename: Conan
authors.initials: C
authors.lastname: MacDougall
authors.forename: B Joseph
authors.initials: BJ
authors.lastname: Guglielmo
authors.forename: Judy
authors.initials: J
authors.lastname: Maselli
authors.forename: Ralph
authors.initials: R
authors.lastname: Gonzales
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003120:Colorado; D017714:Community-Acquired Infections / Q000188:drug therapy; D004363:Drug Utilization; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy*; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones