title: A nationwide survey of physician office visits found that inappropriate antibiotic prescriptions were issued for bacterial respiratory tract infections in ambulatory patients.
abstract: OBJECTIVE
  Correlations between probabilities of resistance and the frequencies with which antibiotics were prescribed for treating bacterial respiratory infections were examined in a nationwide ambulatory population.
  
  
  METHODS
  The data of a nationwide probability sample survey of visits to physician offices in the United States in 1999 were used to conduct this study of drug use. A clinical pharmacologist identified antibiotics prescribed during those visits using a large online database. The participating physicians diagnosed the bacterial respiratory infections. An infectious disease expert determined the probabilities of bacterial resistance from a nationwide antibiotic surveillance database.
  
  
  RESULTS
  Various bacterial respiratory infections were diagnosed during 6.5% of physician office visits in 1999. One or more antibiotics were prescribed during 51.0% of those visits. The probabilities of resistance to the most frequently prescribed antibiotics varied from 20% to 40% and showed a weak positive correlation with the frequencies of antibiotic prescriptions.
  
  
  CONCLUSIONS
  A significant number of inappropriate antibiotic prescriptions were issued for infections with a high probability of bacterial resistance to the prescribed antibiotics.
authors.affiliation: Department of Health Evaluation Sciences, Penn State College of Medicine, 600 Centerview Drive, Hershey, PA 17022-0855, USA. HuangBo@mail.nih.nih.gov
authors.forename: Boji
authors.initials: B
authors.lastname: Huang
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Martin
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Bachmann
authors.forename: Xuming
authors.initials: X
authors.lastname: He
authors.forename: James H
authors.initials: JH
authors.lastname: Reese
authors.forename: Ying
authors.initials: Y
authors.lastname: Wei
authors.forename: Cletus
authors.initials: C
authors.lastname: Iwuagwu
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000553:Ambulatory Care / Q000379:methods*; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D005260:Female; D019538:Health Care Surveys / Q000379:methods*; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D010824:Physicians' Offices; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000453:epidemiology; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D000658:Amoxicillin