Inappropriate antibiotic prescribing high in urgent care centers
Patients seeking care at urgent care centers are much more likely to be prescribed antibiotics for conditions that do not require them than those seeking care at other ambulatory care settings, according to findings published in JAMA Internal Medicine.
“Antibiotic use contributes to antibiotic resistance and is associated with adverse events,” Danielle L. Palms, MPH, from the CDC, and colleagues wrote. “Antibiotic overuse, especially for viral respiratory infections, is common. Only 60% of outpatient antibiotic prescriptions dispensed in the United States are written in traditional ambulatory care settings and EDs. Growing markets, including urgent care centers and retail clinics, may contribute to the remaining 40%.”
Palms and colleagues analyzed data from the 2014 Truven Health MarketScan Commercial Claims and Encounters Database to compare antibiotic prescribing among urgent care centers, retail clinics, EDs and medical offices.
The researchers found that antibiotics were prescribed during 39% of 2.7 million urgent care center visits (95% CI, 39-39.1), 36.4% of 58,206 retail clinic visits (95% CI, 36-36.8), 13.8% of 4.8 million ED visits (95% CI, 13.8-13.8) and 7.1% of 148.5 million medical office visits (95% CI, 7.1-7.1).
A total of 17% of retail clinic visits, 16% of urgent care center visits, 6% of medical office visits, and 5% of ED visits were for antibiotic-inappropriate respiratory diagnoses, such as viral upper respiratory infection, bronchitis/bronchiolitis, asthma/allergy, influenza, nonsuppurative otitis media and viral pneumonia. Urgent care centers had the highest rate of antibiotic prescribing among visits for antibiotic-inappropriate respiratory diagnoses (45.7%), followed by EDs (24.6%), medical offices (17%) and retail clinics (14.4%).
“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%,” Palms and colleagues concluded.
“Antibiotic stewardship interventions could help reduce unnecessary antibiotic prescriptions in all ambulatory care settings, and efforts targeting urgent care centers are urgently needed,” they added. – by Alaina Tedesco
Disclosure: The authors report no relevant financial disclosures.