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Analyzing Antibiotic Use in EDs

Analyzing Antibiotic Use in EDs

Antibiotics are ineffective for treating infections caused by viruses. Inappropriate antibiotic use has been shown to be a contributing factor to antibiotic resistance. Studies indicate that the inappropriate use of antibiotics for acute respiratory tract infections (RTIs) has decreased in many outpatient settings, largely as a result of education and antibiotic stewardship programs. However, little is known about antibiotic utilization patterns in the United States for patients presenting to EDs with acute RTIs. Examining Trends To investigate this issue, John W. Baddley, MD, MSPH, teamed up with colleagues in the ED to examine data from the National Hospital Ambulatory Medical Care Survey from 2001 to 2010. In a study published in Antimicrobial Agents and Chemotherapy, they identified patients presenting to EDs with acute RTIs and calculated rates of antibiotic utilization. Diagnoses were classified as antibiotic-appropriate for cases of otitis media, sinusitis, pharyngitis, tonsillitis, and non-viral pneumonia. Diagnoses were antibiotic-inappropriate for cases of nasopharyngitis, unspecified upper RTIs, bronchitis or bronchiolitis, viral pneumonia, and influenza.     According to the results, acute RTIs accounted for 126 million visits to U.S. EDs during the study period examined, or about 12% of all ambulatory care visits nationally. “Antibiotics were prescribed in 61% of acute RTIs even though many of these infections were viral and did not require treatment with these medications,” says Dr. Baddley. “Oftentimes, antibiotics were inappropriately prescribed for acute RTIs that were likely caused by a virus.” Between 2001 and 2010, inappropriate antibiotic use decreased in pediatric settings but not in adult settings. “Considering the efforts to promote antibiotic stewardship, we expected to see a decrease in ED antibiotic use for...
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