Antimicrobial prescribing for upper respiratory infections and its effect on return visits

Area of Science:

• Public Health
• Infectious Diseases
• Health Services Research

Background:

• Antibiotic resistance is a significant global health challenge.
• Appropriate antibiotic prescribing is crucial for managing respiratory tract infections (RTIs).
• Understanding prescribing patterns and their impact on patient outcomes is essential.

Purpose of the Study:

• To analyze antibiotic prescribing rates for common RTIs among Oregon Medicaid patients.
• To evaluate the association between antibiotic receipt at an initial visit and subsequent return visits within 30 days.

Main Methods:

• Analysis of Oregon Medicaid encounter data from 2001-2003.
• Inclusion of patients with diagnoses of bronchitis, sinusitis, acute otitis media (AOM), pharyngitis, and upper respiratory infections (URIs).
• Examination of antibiotic receipt within 3 days of index visit and 30-day return visit data.

Main Results:

• Antibiotic prescribing for bronchitis and sinusitis decreased between 2001 and 2003.
• Prescribing rates for acute otitis media, upper respiratory infections, and pharyngitis remained relatively stable.
• Patients receiving antibiotics for AOM, URI, and pharyngitis were more likely to have a return visit for RTIs within 30 days.

Conclusions:

• Overall antibiotic prescribing for RTIs among Oregon Medicaid patients has declined.
• Antibiotic use at an index visit did not reduce the likelihood of subsequent return visits for RTIs.