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Antibiotics 2017, 6(4), 22; doi:10.3390/antibiotics6040022

Antibiotic Prescribing for Uncomplicated Acute Bronchitis Is Highest in Younger Adults

1
Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX 77098, USA
2
Baylor College of Medicine, Houston, TX 77030, USA
3
Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
4
Houston VA Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA
*
Author to whom correspondence should be addressed.
Received: 11 September 2017 / Revised: 19 October 2017 / Accepted: 25 October 2017 / Published: 27 October 2017
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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. View Full-Text
Keywords: antimicrobial stewardship; antimicrobial resistance; bronchitis; primary care antimicrobial stewardship; antimicrobial resistance; bronchitis; primary care
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Grigoryan, L.; Zoorob, R.; Shah, J.; Wang, H.; Arya, M.; Trautner, B.W. Antibiotic Prescribing for Uncomplicated Acute Bronchitis Is Highest in Younger Adults. Antibiotics 2017, 6, 22.

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