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Antimicrobial Prescription Patterns for Acute Sinusitis 2015-2022: A Comparison to Published Guidelines
Sarit Dhar1, Dhruv S Kothari2, Ana L Tomescu1
1Department of Otolaryngology - Head & Neck Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.
Physician antibiotic prescribing for acute rhinosinusitis (ARS) frequently deviates from guidelines. Amoxicillin-based therapies are recommended, but macrolides are often overused, potentially increasing antibiotic resistance.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Pharmacology
Background:
- Acute rhinosinusitis (ARS) is a common condition in primary care and otolaryngology.
- Current antibiotic prescribing practices for ARS are not well understood in relation to established guidelines.
Purpose of the Study:
- To examine the epidemiology of ARS.
- To evaluate antibiotic prescribing patterns for ARS.
- To compare prescribing practices against 2015 American Academy of Otolaryngology guidelines.
Main Methods:
- Utilized the TriNetX Live database for patient identification (ICD10 code J01).
- Analyzed data from April 2015 to December 2022 in Tennessee.
- Compared initial antibiotic prescriptions within one day of ARS diagnosis to guidelines.
Main Results:
- 81,310 ARS patients were identified; 69.8% received antibiotics within one day.
- Amoxicillin/clavulanate (25.3%) and amoxicillin (16.4%) were prescribed, but macrolides (25.8%) were most common.
- Only 42.2% of antibiotic prescriptions adhered to guideline recommendations.
Conclusions:
- Physician adherence to ARS antibiotic guidelines is suboptimal.
- Overreliance on macrolides, despite resistance concerns, is prevalent.
- Increased physician awareness and further research into prescribing patterns are recommended for improved antibiotic stewardship.
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