Antibiotics in Emergency Rooms
Inappropriate antibiotic prescribing for acute respiratory tract infections (ARTIs) has declined in recent years, but some work still needs to be done, particularly in emergency departments (EDs), say researchers from the University of North Carolina. Even though fewer antibiotics were prescribed between 1995 and 2000, the researchers noted that too many were still being prescribed.
Of more than 50 million visits to EDs for ARTIs, 62% of these resulted in a prescription for an antibiotic. There were fewer prescriptions for ARTIs for which antibiotic therapy is nearly always inappropriate, such as nasopharyngitis and acute bronchitis (from 57% to 44%), but the downward trend was observed mostly in urban hospitals. Prescribing patterns remained virtually unchanged in the more rural areas.
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Antibiotics were 57% less likely to be prescribed for adult ARTIs of unspecified or multiple sites and 80% less likely for nasopharyngitis, compared with ED visits for bronchitis. Nationally, the likelihood of antibiotic prescribing for children with ARTIs during emergency visits was approximately twice as high when the health providers were staff physicians or nonphysicians with hospital privileges than during visits in which residents or intern physicians were included.
When children with ARTIs arrived in the ED after 10 P.M., antibiotics were 30% more likely to be prescribed.
