Antibiotic Prescription Pattern for Viral Respiratory Illness in Emergency Room and Ambulatory Care Settings

This retrospective study from Illinois attempted to evaluate the current practice pattern of antibiotic prescription rate among different specialty health care providers in children diagnosed with a viral respiratory tract infection. Using International Classification of Diseases-9^th Revision (ICD-9) diagnostic codes, 6314 patients were identified as having been seen for viral illnesses in any of the primary care providers' offices, convenience care clinics (ambulatory care centers), or emergency departments. From this number, a convenience sample of 400 was taken from each care setting and screened for suitability. After excluding patients with otitis media, culture-positive strep pharyngitis, duplicate visits, and those without a recorded diagnosis, 904 patients remained for further study. The overall antibiotic prescription rate for these patients was 30%. Antibiotic prescription rate was 3.7 times (95% confidence interval [CI] 1.90–7.31) higher for patients diagnosed as bronchitis and 2.5 times (95% CI 1.46–4.30) higher for patients diagnosed as viral pharyngitis than for patients diagnosed with a common cold. Antibiotics prescriptions were written more by emergency physicians (odds ratio [OR] 11.04; 95% CI 5.78–21.10) and family practitioners (OR 5.22; 95% CI 2.99–9.10) than by pediatricians. The authors concluded that Emergency Medicine physicians and Family practitioners were more likely to prescribe antibiotics than pediatricians.