WEDNESDAY, Oct. 2, 2019 (HealthDay News) — In outpatient settings, only 50 percent of visits for pharyngitis, sinusitis, and acute otitis media (AOM) receive recommended first-line antibiotics, according to a study published online Sept. 23 in Antimicrobial Agents and Chemotherapy.

Danielle L. Palms, M.P.H., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues compared antibiotic selection for pediatric and adult visits for pharyngitis and sinusitis and pediatric visits for AOM in retail clinics, emergency departments, urgent cares, and offices.

The researchers found that at 50 percent of the antibiotic visits to retail clinics (total 13,889 visits), emergency departments (total 107,820 visits), urgent cares (total 474,378 visits), and offices (total 4,268,329 visits), patients received first-line antibiotics. The percent of visits during which first-line therapy was prescribed for all three conditions was 70 percent in retail clinics and 57, 49, and 50 percent in emergency departments, urgent cares, and offices, respectively. The rate of first-line therapy was higher for children than adults in all settings (62 versus 41 percent). For adults, the rate of first-line therapy was highest in retail clinics compared with emergency departments, urgent cares, and offices (68 percent versus 45, 44, and 40 percent, respectively). First-line therapy varied from 78 percent in retail clinics and emergency departments to 69 percent in urgent care visits for pediatric AOM.

“All settings can improve antibiotic selection, as first-line therapy should be used in at least 80 percent of visits for these conditions,” the authors write.

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