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Assessing the Impact of Geo-Demographic Factors on Antibiotic Prescribing Among Ambulatory Adults with Acute, Uncomplicated Bronchitis or Upper Respiratory Tract Infection

Thomas J. Dilworth, PharmD; Kayla Hietpas, MPH; Jessica Kram, MPH; Dennis Baumgardner, MD

Corresponding Author:  Thomas J. Dilworth, PharmD; Department of Pharmacy Services - Advocate Aurora Health.

Contact Email: thomas.dilworth@aah.org

Section: Original Research

Published Version: www.jabfm.org/content/35/4/733

OBJECTIVE: To assess the impact of geo-demographic 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.

ABSTRACTS IN PRESS

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