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Research ArticleOriginal Research

Impact of Geodemographic Factors on Antibiotic Prescribing for Acute, Uncomplicated Bronchitis or Upper Respiratory Tract Infection

Thomas J. Dilworth, Kayla Hietpas, Jessica J. F. Kram and Dennis Baumgardner
The Journal of the American Board of Family Medicine July 2022, 35 (4) 733-741; DOI: https://doi.org/10.3122/jabfm.2022.04.210452
Thomas J. Dilworth
From Department of Pharmacy Services, Advocate Aurora Health, Milwaukee, WI (TJD); Advocate Aurora Research Institute, Advocate Aurora Health, Milwaukee, WI (KH); Aurora UW Medical Group, Aurora Sinai Medical Center, Advocate Aurora Health, Milwaukee, WI (KH, JK); Center for Urban Population Health, Milwaukee, WI (JK, DB); Department of Family Medicine, Aurora UW Medical Group, Aurora St. Luke's Medical Center, Advocate Aurora Health, Milwaukee, WI (DB).
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Kayla Hietpas
From Department of Pharmacy Services, Advocate Aurora Health, Milwaukee, WI (TJD); Advocate Aurora Research Institute, Advocate Aurora Health, Milwaukee, WI (KH); Aurora UW Medical Group, Aurora Sinai Medical Center, Advocate Aurora Health, Milwaukee, WI (KH, JK); Center for Urban Population Health, Milwaukee, WI (JK, DB); Department of Family Medicine, Aurora UW Medical Group, Aurora St. Luke's Medical Center, Advocate Aurora Health, Milwaukee, WI (DB).
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Jessica J. F. Kram
From Department of Pharmacy Services, Advocate Aurora Health, Milwaukee, WI (TJD); Advocate Aurora Research Institute, Advocate Aurora Health, Milwaukee, WI (KH); Aurora UW Medical Group, Aurora Sinai Medical Center, Advocate Aurora Health, Milwaukee, WI (KH, JK); Center for Urban Population Health, Milwaukee, WI (JK, DB); Department of Family Medicine, Aurora UW Medical Group, Aurora St. Luke's Medical Center, Advocate Aurora Health, Milwaukee, WI (DB).
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Dennis Baumgardner
From Department of Pharmacy Services, Advocate Aurora Health, Milwaukee, WI (TJD); Advocate Aurora Research Institute, Advocate Aurora Health, Milwaukee, WI (KH); Aurora UW Medical Group, Aurora Sinai Medical Center, Advocate Aurora Health, Milwaukee, WI (KH, JK); Center for Urban Population Health, Milwaukee, WI (JK, DB); Department of Family Medicine, Aurora UW Medical Group, Aurora St. Luke's Medical Center, Advocate Aurora Health, Milwaukee, WI (DB).
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Abstract

Objective: To assess the impact of geodemographic factors on antibiotic prescribing for adult acute, uncomplicated bronchitis or upper respiratory tract infection.

Methods: A retrospective, observational study of 63,051 single health-system, outpatient discharges with a primary diagnosis of bronchitis or upper respiratory tract infection in 2019. Univariate analyses of prescribing predictors and multivariable stepwise logistic modeling were performed.

Results: Patients who were older (aOR 1.02; 95% CI 1.02, 1.02), male (1.10; 1.06, 1.14), black (1.29; 1.22, 1.38), smoked (1.18; 1.14, 1.23), seen in urgent care (1.26; 1.22, 1.31) and living in an area with more owner-occupied housing (1.41; 1.30, 1.53) were more likely to receive antibiotics. Patients who were Asian (0.88; 0.77, 0.99), had Medicare (0.83; 0.78, 0.87), Medicaid (0.84; 0.79, 0.87) or Exchange insurance (0.90; 0.82, 0.98), or seen in the emergency department (0.43; 0.40, 0.46) were less likely to receive antibiotics. Distance from a patient's address and their encounter location did not predict antibiotic prescribing.

Conclusions: Antibiotic prescribing interventions for adult acute bronchitis and upper respiratory tract infections could target patients living in an area with higher socioeconomic status.

  • Antibiotics
  • Antimicrobial Stewardship
  • Bronchitis
  • Pharmaceutical Preparations
  • Respiratory Tract Infections
  • Retrospective Studies
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The Journal of the American Board of Family     Medicine: 35 (4)
The Journal of the American Board of Family Medicine
Vol. 35, Issue 4
July/August 2022
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Impact of Geodemographic Factors on Antibiotic Prescribing for Acute, Uncomplicated Bronchitis or Upper Respiratory Tract Infection
Thomas J. Dilworth, Kayla Hietpas, Jessica J. F. Kram, Dennis Baumgardner
The Journal of the American Board of Family Medicine Jul 2022, 35 (4) 733-741; DOI: 10.3122/jabfm.2022.04.210452

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Impact of Geodemographic Factors on Antibiotic Prescribing for Acute, Uncomplicated Bronchitis or Upper Respiratory Tract Infection
Thomas J. Dilworth, Kayla Hietpas, Jessica J. F. Kram, Dennis Baumgardner
The Journal of the American Board of Family Medicine Jul 2022, 35 (4) 733-741; DOI: 10.3122/jabfm.2022.04.210452
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Keywords

  • Antibiotics
  • Antimicrobial Stewardship
  • Bronchitis
  • Pharmaceutical Preparations
  • Respiratory Tract Infections
  • Retrospective Studies

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