Acute respiratory tract infection: A practice examines its antibiotic prescribing habits

Michael L. Grover, Martina Mookadam, Richard H. Rutkowski, Allison M. Cullan, Destin E. Hill, David C. Patchett, Esan O. Simon, MariLynn Mulheron, Brie N. Noble

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose ▶ We wanted to better understand our practice behaviors by measuring antibiotic prescribing patterns for acute respiratory tract infections (ARTIs), which would perhaps help us delineate goals for quality improvement interventions. We determined (1) the distribution of ARTI final diagnoses in our practice, (2) the frequency and types of antibiotics prescribed, and (3) the factors associated with antibiotic prescribing for patients with ARTI. Methods ▶ We looked at office visits for adults with ARTI symptoms that occurred between December 14, 2009, and March 4, 2010. We compiled a convenience sample of 438 patient visits, collecting historical information, physical examination findings, diagnostic impressions, and treatment decisions. Results ▶ Among the 438 patients, cough was the most common presenting complaint (58%). Acute sinusitis was the most frequently assigned final diagnosis (32%), followed by viral upper respiratory tract infection (29%), and acute bronchitis (24%). Sixty-nine percent of all ARTI patients (304/438) received antibiotic prescriptions, with macrolides being most commonly prescribed (167/304 [55%]). Prescribing antibiotics was associated with a complaint of sinus pain or shortness of breath, duration of illness ≥8 days, and specific abnormal physical exam findings. Prescribing rates did not vary based on patient age or presence of risk factors associated with complication. Variations in prescribing rates were noted between individual providers and groups of providers. Conclusions ▶ We found that we prescribed antibiotics at high rates. Diagnoses of acute sinusitis and bronchitis may have been overused as false justification for antibiotic therapy. We used broad-spectrum antibiotics frequently. We have identified several gaps between current and desired performance to address in practice-based quality improvement interventions.

Original languageEnglish (US)
Pages (from-to)330-335
Number of pages6
JournalJournal of Family Practice
Volume61
Issue number6
StatePublished - Jun 2012

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Respiratory Tract Infections
Habits
Anti-Bacterial Agents
Bronchitis
Sinusitis
Quality Improvement
Office Visits
Sick Leave
Macrolides
Cough
Dyspnea
Physical Examination
Prescriptions
Pain
Therapeutics

ASJC Scopus subject areas

  • Family Practice

Cite this

Grover, M. L., Mookadam, M., Rutkowski, R. H., Cullan, A. M., Hill, D. E., Patchett, D. C., ... Noble, B. N. (2012). Acute respiratory tract infection: A practice examines its antibiotic prescribing habits. Journal of Family Practice, 61(6), 330-335.

Acute respiratory tract infection : A practice examines its antibiotic prescribing habits. / Grover, Michael L.; Mookadam, Martina; Rutkowski, Richard H.; Cullan, Allison M.; Hill, Destin E.; Patchett, David C.; Simon, Esan O.; Mulheron, MariLynn; Noble, Brie N.

In: Journal of Family Practice, Vol. 61, No. 6, 06.2012, p. 330-335.

Research output: Contribution to journalArticle

Grover, ML, Mookadam, M, Rutkowski, RH, Cullan, AM, Hill, DE, Patchett, DC, Simon, EO, Mulheron, M & Noble, BN 2012, 'Acute respiratory tract infection: A practice examines its antibiotic prescribing habits', Journal of Family Practice, vol. 61, no. 6, pp. 330-335.
Grover ML, Mookadam M, Rutkowski RH, Cullan AM, Hill DE, Patchett DC et al. Acute respiratory tract infection: A practice examines its antibiotic prescribing habits. Journal of Family Practice. 2012 Jun;61(6):330-335.
Grover, Michael L. ; Mookadam, Martina ; Rutkowski, Richard H. ; Cullan, Allison M. ; Hill, Destin E. ; Patchett, David C. ; Simon, Esan O. ; Mulheron, MariLynn ; Noble, Brie N. / Acute respiratory tract infection : A practice examines its antibiotic prescribing habits. In: Journal of Family Practice. 2012 ; Vol. 61, No. 6. pp. 330-335.
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