title: Antibiotic use for viral acute respiratory tract infections remains common.
abstract: OBJECTIVE
  To determine the type and number of antibiotic prescriptions filled in the 28 days following an index visit for acute respiratory tract infections (ARTIs) generally presumed to be viral.
  
  
  METHODS
  This was a secondary analysis of administrative data.
  
  
  METHODS
  We linked administrative data for pharmacy, clinical encounters, and providers to identify all prescriptions for a relevant antibiotic filled within 28 days of an index visit for an ARTI. Data were analyzed descriptively. The primary outcome was whether or not the patient was prescribed an antibiotic or anti-influenza medication for an episode of presumed viral ARTI.
  
  
  RESULTS
  There were 54,656 encounters for presumed viral ARTI. Most visits (84.4%) were to a primary care clinician, with 12% to an urgent care center and 3.6% to the emergency department. Within 28 days of an encounter for a presumed viral upper respiratory tract infection, 49.4% of patients filled an initial antibiotic prescription, 4.8% a prescription for an anti-influenza drug, and 1.2% received both. A second antibiotic prescription was filled after the initial prescription by 8.9% of patients, and a third by 0.7%. Antibiotic use was most common for acute bronchitis (67.8%) and in the urgent care setting (60.2%). Antibiotics were prescribed less often by pediatricians, whereas anti-influenza medications were prescribed most often for patients aged 5 to 17 years by both pediatricians and family physicians. Antibiotic use has increased since 2007, when azithromycin became a generic drug.
  
  
  CONCLUSIONS
  Prescribing antibiotics for ARTIs that are likely to be viral in origin remains common, despite extensive public health educational efforts.
authors.affiliation: 233 Miller Hall, UGA Health Sciences Campus, Athens, GA 30602. E-mail: ebell@uga.edu.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Ebell
authors.forename: Taylor
authors.initials: T
authors.lastname: Radke
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization / Q000592:standards* / Q000639:trends; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000639:trends*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000821:virology; D012189:Retrospective Studies; D015144:Southeastern United States; D014777:Virus Diseases / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents