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Geographic Variability in Diagnosis and Antibiotic Prescribing for Acute Respiratory Tract Infections

Adam L Hersh1, Daniel J Shapiro2,3, Andrew T Pavia4

  • 1Pediatric Infectious Diseases, University of Utah, Salt Lake City, UT, USA. adam.hersh@hsc.utah.edu.

Infectious Diseases and Therapy
|December 24, 2017
PubMed
Abstract

Insights

Regional variations in US antibiotic prescribing for respiratory conditions are linked to diagnosis rates. Higher diagnosis rates correlate with increased antibiotic prescriptions, suggesting overdiagnosis may drive prescribing differences.

Area of Science:

  • Public Health
  • Epidemiology
  • Health Services Research

Background:

  • Antibiotic prescribing rates exhibit significant regional disparities within the USA.
  • The underlying drivers of these prescribing variations—overtreatment versus overdiagnosis—remain unclear.

Purpose of the Study:

  • To investigate the relationship between regional differences in antibiotic prescribing for respiratory conditions and the diagnosis rates of these conditions.

Main Methods:

  • Utilized data from the National Ambulatory Medical Care Survey (2012-2013).
  • Analyzed the association between respiratory diagnosis visit rates and antibiotic prescription rates across nine US geographic regions.

Main Results:

  • The East South Central Region had the highest antibiotic prescribing rate (176/1000 population) and diagnosis rate (189/1000 population) for relevant respiratory conditions.
  • The Pacific Region showed the lowest rates for both antibiotic prescriptions (109/1000 population) and diagnoses (119/1000 population).

Conclusions:

  • Regional variations in antibiotic prescribing for respiratory conditions are strongly associated with regional diagnosis rates.
  • Findings suggest that differences in diagnosing respiratory conditions may significantly contribute to variations in antibiotic prescribing patterns.
Keywords:
AntibioticInfectionRespiratory tract infectionsStewardship

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