A nationwide survey of physician office visits found that inappropriate antibiotic prescriptions were issued for bacterial respiratory tract infections in ambulatory patients.
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.
Huang
Boji
B
Department of Health Evaluation Sciences, Penn State College of Medicine, 600 Centerview Drive, Hershey, PA 17022-0855, USA. HuangBo@mail.nih.nih.gov
Martin
Steven J
SJ
Bachmann
Kenneth A
KA
He
Xuming
X
Reese
James H
JH
Wei
Ying
Y
Iwuagwu
Cletus
C
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
D000900:Anti-Bacterial Agents; D000658:Amoxicillin