Atlanta—Patients visiting urgent-care centers were most likely to leave with an antibiotic prescription, even if they had a respiratory illness for which the drugs are inappropriate, according to a new study.
The research letter published in JAMA Internal Medicine looked at outpatient antibiotic prescribing among traditional medical and retail clinic settings, as well as during visits with respiratory diagnoses where antibiotics were inappropriate.
“There was substantial variability between settings in the percentage of visits at which antibiotics were prescribed among all visits and among visits for antibiotic-inappropriate respiratory diagnoses,” write the authors from the CDC. “These patterns suggest differences in case mix and evidence of antibiotic overuse, especially in urgent care centers.”
To reach those conclusions, researchers used outpatient claims data from a 2014 database that captures that information for people younger than age 65 years with employer-sponsored insurance. The focus was on urgent-care centers, retail clinics, hospital-based emergency departments, and medical offices.
Results indicate that antibiotic prescriptions were linked to:
• 39.0% of 2.7 million urgent-care center visits (95% CI, 39.0%-39.1%),
• 36.4% of 58,206 retail-clinic visits (95% CI 36.0%-36.8%),
• 13.8% of 4.8 million emergency department (ED) visits (95% CI 13.8%-13.8%), and
• 7.1% of 148.5 million medical-office visits (95% CI 7.1%-7.1%)
The study also found that visits for antibiotic-inappropriate respiratory diagnoses accounted for 17% of 10,009 retail-clinic visits, 16% of 441,605 urgent-care center visits, 6%) of 9.2 million medical-office visits, and 5% of 257,010 of ED visits.
Specifically looking at antibiotic-inappropriate respiratory diagnoses, the CDC researchers determined that antibiotic prescribing was highest in urgent-care centers (45.7%), followed by EDs (24.6%), medical offices (17.0%), and retail clinics (14.4%)
“This finding is important because urgent care and retail clinic markets are growing,” study authors conclude. “Previous work demonstrated that in the 2010-2011 period at least 30% of antibiotic prescriptions written in physician offices and EDs were unnecessary. The finding of the present study that antibiotic prescribing for antibiotic-inappropriate respiratory diagnoses was highest in urgent care centers suggests that unnecessary antibiotic prescribing nationally in all outpatient settings may be higher than the estimated 30%.”
The researchers call for more antibiotic stewardship “across the spectrum of outpatient settings could help to improve antibiotic prescribing and patient care.”
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The research letter published in JAMA Internal Medicine looked at outpatient antibiotic prescribing among traditional medical and retail clinic settings, as well as during visits with respiratory diagnoses where antibiotics were inappropriate.
“There was substantial variability between settings in the percentage of visits at which antibiotics were prescribed among all visits and among visits for antibiotic-inappropriate respiratory diagnoses,” write the authors from the CDC. “These patterns suggest differences in case mix and evidence of antibiotic overuse, especially in urgent care centers.”
To reach those conclusions, researchers used outpatient claims data from a 2014 database that captures that information for people younger than age 65 years with employer-sponsored insurance. The focus was on urgent-care centers, retail clinics, hospital-based emergency departments, and medical offices.
Results indicate that antibiotic prescriptions were linked to:
• 39.0% of 2.7 million urgent-care center visits (95% CI, 39.0%-39.1%),
• 36.4% of 58,206 retail-clinic visits (95% CI 36.0%-36.8%),
• 13.8% of 4.8 million emergency department (ED) visits (95% CI 13.8%-13.8%), and
• 7.1% of 148.5 million medical-office visits (95% CI 7.1%-7.1%)
The study also found that visits for antibiotic-inappropriate respiratory diagnoses accounted for 17% of 10,009 retail-clinic visits, 16% of 441,605 urgent-care center visits, 6%) of 9.2 million medical-office visits, and 5% of 257,010 of ED visits.
Specifically looking at antibiotic-inappropriate respiratory diagnoses, the CDC researchers determined that antibiotic prescribing was highest in urgent-care centers (45.7%), followed by EDs (24.6%), medical offices (17.0%), and retail clinics (14.4%)
“This finding is important because urgent care and retail clinic markets are growing,” study authors conclude. “Previous work demonstrated that in the 2010-2011 period at least 30% of antibiotic prescriptions written in physician offices and EDs were unnecessary. The finding of the present study that antibiotic prescribing for antibiotic-inappropriate respiratory diagnoses was highest in urgent care centers suggests that unnecessary antibiotic prescribing nationally in all outpatient settings may be higher than the estimated 30%.”
The researchers call for more antibiotic stewardship “across the spectrum of outpatient settings could help to improve antibiotic prescribing and patient care.”
« Click here to return to Weekly News Update.
