Association between antibiotic prescribing and visit duration among patients with respiratory tract infections

2021 ◽  
pp. 1-4
Author(s):  
Daniel J. Shapiro ◽  
Laura M. King ◽  
Sharon V. Tsay ◽  
Lauri A. Hicks ◽  
Adam L. Hersh
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Antibiotic Prescribing ◽  
National Data ◽  
Cross Sectional ◽  
Antibiotic Overuse ◽  
Acute Respiratory Tract Infections ◽  
Visit Duration ◽  
Tract Infections ◽  
Sectional Analysis

Abstract Time constraints have been suggested as a potential driver of antibiotic overuse for acute respiratory tract infections. In this cross-sectional analysis of national data from visits to offices and emergency departments, we identified no statistically significant association between antibiotic prescribing and the duration of visits for acute respiratory tract infections.

scholarly journals Antibiotic Prescribing Practices and Errors among Hospitalized Pediatric Patients Suffering from Acute Respiratory Tract Infections: A Multicenter, Cross-Sectional Study in Pakistan

Medicina ◽  
2019 ◽  
Vol 55 (2) ◽  
pp. 44 ◽  
Author(s):  
Sadia Iftikhar ◽  
Muhammad Rehan Sarwar ◽  
Anum Saqib ◽  
Muhammad Sarfraz ◽  
Qurat-ul-ain Shoaib
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Public Hospitals ◽  
P Value ◽  
Antibiotic Prescribing ◽  
Prescribing Errors ◽  
Prescribing Practices ◽  
Cross Sectional ◽  
Acute Respiratory Tract Infections ◽  
Tract Infections

Background and objective: The noncompliance of treatment guidelines by healthcare professionals, along with physiological variations, makes the pediatric population more prone to antibiotic prescribing errors. The present study aims to evaluate the prescribing practices and errors of the most frequently prescribed antibiotics among pediatric patients suffering from acute respiratory tract infections who had different lengths of stay (LOS) in public hospitals. Methods: A retrospective, cross-sectional study was conducted in five tertiary-care public hospitals of Lahore, Pakistan, between 1 January 2017 and 30 June 2017. The study population consisted of pediatric inpatients aged 0 to 9 years. Results: Among the 11,892 pediatric inpatients, 82.8% were suffering from lower acute respiratory tract infections and had long LOS (53.1%) in hospital. Penicillins (52.4%), cephalosporins (16.8%), and macrolides (8.9%) were the most frequently prescribed antibiotics. Overall, 40.8% of the cases had antibiotic prescribing errors related to wrong dose (19.9%), wrong frequency (18.9%), and duplicate therapy (18.1%). Most of these errors were found in the records of patients who had long LOS in hospital (53.1%). Logistic regression analysis revealed that the odds of prescribing errors were lower in female patients (OR = 0.6, 95% CI = 0.1–0.9, p-value = 0.012). Patients who were prescribed with ≥3 antibiotics per prescription (OR = 1.724, 95% CI = 1.1–2.1, p-value = 0.020), had long LOS (OR = 12.5, 95% CI = 10.1–17.6, p-value < 0.001), and were suffering from upper respiratory tract infections (URTI) (OR = 2.8, 95% CI = 1.7–3.9, p-value < 0.001) were more likely to experience prescribing errors. Conclusion: Antibiotics were commonly prescribed to patients who had long LOS. Prescribing errors (wrong dose, wrong frequency, and duplicate therapy) were commonly found in cases of lower respiratory tract infections (LRTIs), especially among those who had prolonged stay in hospital.

scholarly journals Pediatrician Perceptions of an Outpatient Antimicrobial Stewardship Intervention

2014 ◽  
Vol 35 (S3) ◽  
pp. S69-S78 ◽  
Author(s):  
Julia E. Szymczak ◽  
Kristen A. Feemster ◽  
Theoklis E. Zaoutis ◽  
Jeffrey S. Gerber
Keyword(s):  
Primary Care ◽  
Respiratory Tract ◽  
Antimicrobial Stewardship ◽  
Respiratory Tract Infections ◽  
Audit And Feedback ◽  
Antibiotic Prescribing ◽  
Theory Approach ◽  
Antibiotic Overuse ◽  
Acute Respiratory Tract Infections ◽  
Tract Infections

Objective.Inappropriate antibiotic prescribing commonly occurs in pediatric outpatients with acute respiratory tract infections. Antimicrobial stewardship programs are recommended for use in the hospital, but less is known about whether and how they will work in the ambulatory setting. Following a successful cluster-randomized trial to improve prescribing for common acute respiratory tract infections using education plus audit and feedback in a large, pediatric primary care network, we sought to explore the perceptions of the intervention and antibiotic overuse among participating clinicians.Methods.We conducted a qualitative study using semistructured interviews with 24 pediatricians from 6 primary care practices who participated in an outpatient antimicrobial stewardship intervention. All interviews were transcribed and analyzed using a modified grounded theory approach.Results.Deep skepticism of the audit and feedback reports emerged. Respondents ignored reports or expressed distrust about them. One respondent admitted to gaming behavior. When asked about antibiotic overuse, respondents recognized it as a problem, but they believed it was driven by the behaviors of nonpediatric physicians. Parent pressure for antibiotics was identified by all respondents as a major barrier to the more judicious use of antibiotics. Respondents reported that they sometimes “caved” to parent pressure for social reasons.Conclusions.To improve the effectiveness and sustainability of outpatient antimicrobial stewardship, it is critical to boost the credibility of audit data, engage primary care pediatricians in recognizing that their behavior contributes to antibiotic overuse, and address parent pressure to prescribe antibiotics.

scholarly journals Antibiotic overuse for acute respiratory tract infections in Sri Lanka: a qualitative study of outpatients and their physicians

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
L. Gayani Tillekeratne ◽  
Champica K. Bodinayake ◽  
Thushani Dabrera ◽  
Ajith Nagahawatte ◽  
Wasantha Kodikara Arachchi ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Qualitative Study ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Antibiotic Overuse ◽  
Acute Respiratory Tract Infections ◽  
Tract Infections

scholarly journals Inappropriate antibiotic use for respiratory infections in outpatient settings

2021 ◽  
Vol 15 (2) ◽  
pp. 67-71
Author(s):  
Saman Omer ◽  
Bushra Tayyaba Khan ◽  
Omer Jalil ◽  
Muhammad Waqar Aslam Khan ◽  
Quratulain Mehdi ◽  
...  
Keyword(s):  
Public Health ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Prescribing Indicators ◽  
Acute Respiratory Tract Infections ◽  
Prescribing Trends ◽  
Tract Infections

Background: Overuse of antibiotics is a significant problem in low- and middle-income countries where recommended treatment guidelines are not routinely practiced, resulting in antimicrobial resistance. Acute respiratory tract infections, mostly viral in origin, remain the clinical category for most commonly prescribed antibiotics. Due to the lack of local evidence about antibiotic prescribing trends in such infections, this study was conducted to evaluate the prescribing patterns in general and antibiotic prescribing trends specifically in prescriptions with the diagnosis of acute respiratory infections in district Mirpur of Azad Kashmir. Patients and methods: A prospective cross-sectional study carried out in the Department of Pharmacology and Therapeutics, Army Medical College, Rawalpindi, and outpatient departments of public health facilities in district Mirpur, Kashmir, from Aug to Oct 2020. Data were collected from 10 different public health facilities in District Mirpur, Kashmir including, three rural health centers (RHC) and five basic health units (BHU). Prescribing pattern analysis by objective observations of the prescriptions after patient-physician encounter against the World Health Organization defined core prescribing indicators. The appropriateness of antibiotic use was analyzed against clinical practice guidelines. IBM SPSS Statistics for Windows, Version 26 was used for data analysis. Descriptive analysis was done to find frequencies and percentages for categorical data and means and standard deviation for continuous data. Results: Total number of prescriptions evaluated was 144. Number of prescriptions containing antibiotics was 118 (82%) (standard, 20 - 26.8%). Inappropriate use of antibiotics was seen in 78% of cases where no antibiotics were indicated. The average number of medicines per prescription was 3.11 (standard, 2.1), whereas 79% of medicines prescribed were from the national essential medicine list (standard, 100%). Only 2.5% (standard, 100%) of the medications were prescribed with generic names. Conclusion: This study shows an inappropriate and overuse of antibiotics for acute respiratory tract infections, indicating a lack of adherence to core prescribing indicators and clinical guidelines by the physicians in outpatient clinics of Mirpur.

scholarly journals Antibiotic prescribing for acute respiratory tract infections in primary care: an updated and expanded meta-ethnography

2018 ◽  
Vol 68 (674) ◽  
pp. e633-e645 ◽  
Author(s):  
Evi Germeni ◽  
Julia Frost ◽  
Ruth Garside ◽  
Morwenna Rogers ◽  
Jose M Valderas ◽  
...  
Keyword(s):  
Primary Care ◽  
Respiratory Tract ◽  
Usual Care ◽  
Respiratory Tract Infections ◽  
Antibiotic Prescribing ◽  
Qualitative Synthesis ◽  
Acute Respiratory Tract Infections ◽  
Context Sensitive ◽  
Quality Improvement Interventions ◽  
Tract Infections

BackgroundReducing unnecessary prescribing remains a key priority for tackling the global rise of antibiotic-resistant infections.AimThe authors sought to update a 2011 qualitative synthesis of GPs’ experiences of antibiotic prescribing for acute respiratory tract infections (ARTIs), including their views of interventions aimed at more prudent prescribing. They expanded the original scope to encompass all primary care professionals (PCPs) who can prescribe or dispense antibiotics for ARTIs (for example, nurses and pharmacists).Design and settingSystematic review and meta-ethnography of qualitative studies.MethodA systematic search was conducted on MEDLINE, EMBASE, PsycINFO, CINAHL, ASSIA, and Web of Science. No date or language restrictions were used. Identified studies were grouped according to their thematic focus (usual care versus intervention), and two separate syntheses were performed.ResultsIn all, 53 articles reporting the experiences of >1200 PCPs were included. Analysis of usual-care studies showed that PCPs tend to assume multiple roles in the context of ARTI consultations (the expert self, the benevolent self, the practical self), depending on the range of intrapersonal, interpersonal, and contextual situations in which they find themselves. Analysis of intervention studies identified four possible ways in which PCPs may experience quality improvement interventions (compromise, ‘supportive aids’, source of distress, and unnecessary).ConclusionContrary to the original review, these results suggest that the use of the same intervention is experienced in a totally different way by different PCPs, and that the same elements that are perceived as benefits by some could be viewed as drawbacks by others. Acceptability of interventions is likely to increase if these are context sensitive and take into account PCPs’ varying roles and changing priorities.

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