Antibiotic Prescribing for Uncomplicated Acute Bronchitis Is Highest in Younger Adults
Larissa Grigoryan1, Roger Zoorob2, Jesal Shah3
1Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX 77098, USA. grigorya@bcm.edu.
Insights
Reducing antibiotic prescribing for acute uncomplicated bronchitis is crucial. Over 60% of patients received antibiotics, especially younger adults, highlighting a need for improved prescribing practices.
Area of Science:
- General Medicine
- Infectious Diseases
- Public Health
Background:
- Antibiotic resistance is a significant global health concern.
- Guidelines advise against antibiotic use for acute uncomplicated bronchitis.
- Inappropriate antibiotic prescribing remains a persistent challenge.
Purpose of the Study:
- To analyze antibiotic prescribing patterns for acute uncomplicated bronchitis.
- To identify factors predicting inappropriate antibiotic prescribing in this condition.
- To inform strategies for reducing unnecessary antibiotic use.
Main Methods:
- Retrospective analysis of electronic health records from family medicine clinics (2011-2016).
- Inclusion of adult patients diagnosed with acute bronchitis, excluding those with conditions justifying antibiotic use.
- Statistical analysis to determine prescribing rates and associated demographic predictors.
Main Results:
- 62.1% of 3616 visits for acute uncomplicated bronchitis resulted in antibiotic prescriptions.
- Antibiotic prescribing rates were highest in younger adults (18-39 years) at 66.9%.
- Macrolides were more common in younger patients, fluoroquinolones in older patients (≥65 years).
Conclusions:
- A high rate of inappropriate antibiotic prescribing for acute uncomplicated bronchitis persists.
- Younger adults are disproportionately prescribed antibiotics for this condition.
- Interventions are urgently needed to curb antibiotic overuse in acute bronchitis, particularly among younger populations.
Abstract:
Reducing inappropriate antibiotic prescribing is currently a global health priority. Current guidelines recommend against antibiotic treatment for acute uncomplicated bronchitis. We studied antibiotic prescribing patterns for uncomplicated acute bronchitis and identified predictors of inappropriate antibiotic prescribing. We used the Epic Clarity database (electronic medical record system) to identify all adult patients with acute bronchitis in family medicine clinics from 2011 to 2016. We excluded factors that could justify antibiotic use, such as suspected pneumonia, COPD or immunocompromising conditions. Of the 3616 visits for uncomplicated acute bronchitis, 2244 (62.1%) resulted in antibiotic treatment. The rates of antibiotic prescribing were similar across the years, p value for trend = 0.07. Antibiotics were most frequently prescribed in the age group of 18-39 years (66.9%), followed by the age group of 65 years and above (59.0%), and the age group of 40-64 years (58.7%), p value < 0.001. Macrolides were significantly more likely to be prescribed for younger adults, while fluoroquinolones were more likely to be prescribed for patients 65 years or older. Duration of antibiotic use was significantly longer in older adults. Sex and race were not associated with antibiotic prescribing. Our findings highlight the urgent need to reduce inappropriate antibiotic use for uncomplicated acute bronchitis, particularly in younger adults.
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