Antibiotics are one of the most commonly overprescribed drug classes. A study published in theAmerican Journal of Managed Carecompared the writing of antibiotic prescriptions for the diagnosis of acute respiratory infections (ARIs) across 3 different health care facilities: retail clinics, emergency departments (EDs), and primary care physicians’ (PCPs) offices.
The study took data from all visits between 2007 and 2009 from retail clinics, ambulatory practices, outpatient hospital practices, and ED visits regarding ARIs. UsingICD-9-CMdiagnosis codes, the ARI diagnoses were split into 2 categories depending on the infection: antibiotics may be appropriate and antibiotics are never appropriate.
According to the study results, several differences became apparent: across the 3 sites, the amount of antibiotic prescriptions written for all ARIs were similar, implying the shift toward retail-clinic care will not impact antibiotic prescribing. In addition, the results showed that retail clinics were more likely to write prescriptions for narrow-spectrum antibiotics when they were deemed appropriate to use; EDs and PCPs wrote prescriptions for broad‑spectrum antibiotics instead, and wrote them less often (95% and 85%, respectively). Also, when antibiotics were deemed never appropriate, retail clinics were less likely to write a prescription for an antibiotic (33%) than either the ED or a PCP office (50%).
Overall, despite the fact that retail clinics write the same amount of antibiotic prescriptions as EDs or PCP offices, they are more likely to write them during visits for ARIs where antibiotics may be deemed appropriate and less likely when they are not appropriate, according to their diagnoses. These results show that as the shift toward the use of retail clinics increases, patient care is similar compared with other health care sites in the treatment of ARIs.
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