Substantial variation in antibiotic prescribing habits among individual providers at the VA
THURSDAY, Aug. 13, 2015 (HealthDay News) — Though antibiotic prescribing for acute respiratory infections (ARIs) varies greatly among providers, veterans with ARIs commonly receive antibiotics, according to a study published in the July 21 issue of the Annals of Internal Medicine.
Barbara Ellen Jones, M.D., from the Veterans Affairs Salt Lake City Health Care System, and colleagues examined trends in antibiotic prescribing in Veterans Affairs emergency departments and primary and urgent care clinics over an eight-year period (2005 to 2012). Patients had primary diagnoses of ARIs that typically had low proportions of bacterial infection.
The researchers found that the proportion of one million visits with ARI diagnoses that resulted in antibiotic prescriptions increased from 67.5 percent in 2005 to 69.2 percent in 2012. Among prescriptions, the proportion of macrolide antibiotics prescribed increased from 36.8 percent to 47 percent. Antibiotic prescribing varied little by fever, age, setting, or comorbid conditions but was highest for sinusitis (adjusted proportion, 86 percent) and bronchitis (85 percent). Provider-level variation in prescribing was substantial, with the 10 percent of providers who prescribed the most antibiotics doing so during at least 95 percent of their ARI visits. By contrast, the 10 percent who prescribed the least did so during 40 percent or fewer of their ARI visits.
“Veterans with ARIs commonly receive antibiotics, regardless of patient, provider, or setting characteristics,” the authors write.
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