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Inappropriate Antibiotic Prescribing for Acute Bronchiolitis in US Emergency Departments, 2007-2015

Jesse Papenburg1,2, Patricia S Fontela1,3, Raphael R Freitas4

  • 1Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.

Journal of the Pediatric Infectious Diseases Society
|January 19, 2019
PubMed

Insights

Unnecessary antibiotic use for bronchiolitis remains high, with 25% of patients receiving antibiotics despite lacking bacterial infections. National guidelines have not curbed this trend, highlighting the need for improved prescribing practices.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Pharmacology

Background:

  • Bronchiolitis is a common viral respiratory infection in infants and young children.
  • Antibiotic overuse for viral infections like bronchiolitis contributes to antimicrobial resistance.
  • Current guidelines recommend against routine antibiotic use for bronchiolitis.

Purpose of the Study:

  • To analyze antibiotic prescribing patterns for bronchiolitis in US emergency departments.
  • To assess the impact of national guidelines on antibiotic use for bronchiolitis.
  • To identify the extent of inappropriate antibiotic prescribing for bronchiolitis.

Main Methods:

  • Retrospective analysis of a large US emergency department database (2007-2015).
  • Examination of antibiotic prescription rates and types.
  • Assessment of bacterial coinfection documentation.

Main Results:

  • One-fourth (25%) of bronchiolitis patients received antibiotics.
  • 70% of antibiotic prescriptions were without documented bacterial coinfection.
  • Macrolides accounted for 38% of antibiotic prescriptions.
  • Antibiotic use did not significantly decrease following guideline publication.

Conclusions:

  • Antibiotic prescribing for bronchiolitis in US emergency departments is frequently inappropriate.
  • National guidelines have been ineffective in reducing unnecessary antibiotic use.
  • Interventions are crucial to minimize inappropriate antibiotic prescribing for bronchiolitis.
Keywords:
antibioticsbronchiolitischildren

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