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Inappropriate Use of Antibiotics in ERs Remains High for Adults

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Inappropriate Use of Antibiotics in ERs Remains High for Adults

Inappropriate use for respiratory tract infection down from 2001 to 2010 for children, not adults

THURSDAY, Jan. 30, 2014 (HealthDay News) -- For patients presenting to the emergency department with acute respiratory tract infections (ARTI), inappropriate utilization of antibiotics has decreased for children, but not for adults, according to a study published online Dec. 16 in Antimicrobial Agents and Chemotherapy.

John P. Donnelly, M.S.P.H., from University of Alabama at Birmingham, and colleagues conducted a retrospective study involving patients presenting to emergency departments with ARTIs from 2001 to 2010 identified from the National Hospital Ambulatory Medical Care Survey. Diagnoses of otitis media, sinusitis, pharyngitis, tonsillitis, and nonviral pneumonia were designated as antibiotic appropriate; while nasopharyngitis, unspecified upper respiratory tract infection, bronchitis or bronchiolitis, viral pneumonia, and influenza were considered antibiotic inappropriate.

The researchers found that antibiotics were prescribed in 61 percent of the 126 million emergency department visits for ARTI. From 2001 to 2010, there was a decrease in antibiotic utilization among patients aged <5 years presenting with antibiotic-inappropriate ARTI (rate ratio [RR], 0.94; confidence interval [CI], 0.88 to 1.00) and among patients aged 5 to 19 years (RR, 0.89; CI, 0.85 to 0.94). Among adult patients aged 20 to 64 years, utilization remained stable for antibiotic-inappropriate ARTI (RR, 0.99; CI, 0.97 to 1.01).

"Although significant progress has been made toward reduction of antibiotic utilization for pediatric patients with ARTI, the proportion of adult ARTI patients receiving antibiotics in U.S. emergency departments is inappropriately high," the authors write.

One author disclosed financial ties to the pharmaceutical industry.

Abstract (http://aac.asm.org/content/early/2013/12/10/AAC.02039-13.abstract )Full Text (subscription or payment may be required) (http://aac.asm.org/content/early/2013/12/10/AAC.02039-13.full.pdf+html )