Predictors of antibiotic prescribing for nonspecific upper respiratory infections, acute bronchitis, and acute sinusitis: An UPRNet study

Steven A. Dosh, John M. Hickner, Arch G. Mainous, Mark H. Ebell

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

BACKGROUND: Antibiotics are often prescribed for viral respiratory infections. The goal of our study was to determine the factors associated with antibiotic prescribing for acute respiratory infections in primary care. METHODS: We performed an observational study in 15 primary care practices in Michigan using patient and physician surveys distributed during visits for acute respiratory infections. We included patients 4 years or older presenting with symptoms of an acute respiratory infection (n=482). The main outcome measures were prescriptions of antibiotics, signs and symptoms associated with antibiotic prescribing, and clinician-reported reasons for prescribing an antibiotic. RESULTS: We found that patients who were older than 18 years, sick for more than 14 days, and seen in urgent care clinics were more likely to receive antibiotics. Patients expected antibiotics if they perceived that the drug had helped with similar symptoms in the past. In an adjusted model, the variables significantly associated with antibiotic prescribing were physical findings of sinus tenderness (odds ratio [OR]=20.0; 95% confidence interval [CI], 8.3-43.2), rales/rhonchi (OR=19.9; 95% CI, 9.2-43.2), discolored nasal discharge (OR=11.7; 95% CI, 4.3-31.7), and postnasal drainage (OR=3.1; 95% CI, 1.6-6.0). The presence of clear nasal discharge on examination was negatively associated (OR=0.3; 95% CI, 0.2-0.5). CONCLUSIONS: Several physical signs play an important role in clinicians' decisions to prescribe antibiotics for respiratory infections. This information will be useful in designing interventions to decrease inappropriate antibiotic prescribing for upper respiratory infections.

Original languageEnglish (US)
Pages (from-to)407-414
Number of pages8
JournalJournal of Family Practice
Volume49
Issue number5
StatePublished - May 1 2000

Fingerprint

Bronchitis
Sinusitis
Respiratory Tract Infections
Anti-Bacterial Agents
Odds Ratio
Confidence Intervals
Respiratory Sounds
Nose
Primary Health Care
Inappropriate Prescribing
Virus Diseases
Ambulatory Care Facilities
Signs and Symptoms
Observational Studies
Prescriptions
Drainage
Outcome Assessment (Health Care)
Physicians

Keywords

  • Antibiotics
  • Bronchitis
  • Respiratory tract infections
  • Sinusitis

ASJC Scopus subject areas

  • Family Practice

Cite this

Predictors of antibiotic prescribing for nonspecific upper respiratory infections, acute bronchitis, and acute sinusitis : An UPRNet study. / Dosh, Steven A.; Hickner, John M.; Mainous, Arch G.; Ebell, Mark H.

In: Journal of Family Practice, Vol. 49, No. 5, 01.05.2000, p. 407-414.

Research output: Contribution to journalArticle

Dosh, Steven A. ; Hickner, John M. ; Mainous, Arch G. ; Ebell, Mark H. / Predictors of antibiotic prescribing for nonspecific upper respiratory infections, acute bronchitis, and acute sinusitis : An UPRNet study. In: Journal of Family Practice. 2000 ; Vol. 49, No. 5. pp. 407-414.
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