Infectious Disease

The implementation of CDC will scale back the prescription of antibiotics for uncomplicated ARIs

January 02, 2021

1 min read

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Disclosure:
Madaras-Kelly reports that she received partial salary support from a CDC-funded grant that was paid to Idaho State University through a subcontract from the University of Utah. In the study you will find all relevant financial information from all other authors.

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According to a recent study in Clinical Infectious Diseases, fewer antibiotics were prescribed for uncomplicated acute upper respiratory infections.

“Acute upper respiratory tract infections (ARI) are one of the most common reasons patients seek care. Most of these infections are caused by viruses and antibiotics are not indicated in most cases. ” Karl Madaras-Kelly, PharmD, MPH, said Healio, a professor in the College of Pharmacy at Idaho State University and a pharmacist at the Pharmacy Service at the Boise Veterans Affairs Medical Center.

“Despite numerous recommendations to limit the prescription of antibiotics for these conditions, doctors continue to prescribe antibiotics for these conditions. Doctors generally understand that antibiotics are not indicated in most cases but continue to be prescribed at high rates due to the perception of prescribing pressure and fear that patients may not get better without them. “

In a quasi-experimental controlled study, Madaras-Kelly and colleagues evaluated the effects of intervention and the introduction of targeted antibiotic prescribing for uncomplicated ARI. According to the study, the results included the prescription of antibiotics per visit, the adequacy of treatment, the potential benefits and complications of reduced antibiotic treatment, and the change in ARI diagnoses over a period of 3 years prior to implementation and a period of one year.

The study found that from 2014 to 2019, 16,712 and 51,275 patients were visited at 10 intervention centers and 40 control centers, respectively.

According to researchers, the pre-implementation antibiotic prescribing rates at intervention centers were 59.7% and 41.5%, while at control centers they were 73.5% and 67.2% (P <0.001). In addition, the study showed that the odds ratio increased before the intervention center was implemented for appropriate therapy (1.67; 1.312.14), while it remained unchanged at the control sites (1.04; 0.911.19).

The study also showed that there was no difference in ARI-related return visits after implementation (1.3% versus -2.0%; P = 0.76), but hospitalization of all causes at the intervention centers was lower (- 0.5% versus -0.2)%; P = 0.02].

“Feedback on doctor prescribing rates compared to peers has reduced the prescription of antibiotics for conditions where antibiotics are rarely indicated,” said Madaras-Kelly. “The practice was safe and may be associated with improved results. Program administrators should recognize that similar interventions can affect diagnostic coding practices. “

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