Inappropriate Antibiotic Use for Acute Bronchitis Highest in Younger Adults

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Adhering to treatment guidelines for acute bronchitis could eliminate 7.8 million unnecessary prescriptions annually.
Adhering to treatment guidelines for acute bronchitis could eliminate 7.8 million unnecessary prescriptions annually.

Overprescription of antibiotics for uncomplicated acute bronchitis is common despite current guidelines recommending against this practice, particularly in younger adults, according to research published in Antibiotics.

Using the Epic Clarity database of electronic medical records, adult patients with acute bronchitis visiting family medical clinics between 2011 and 2016 were identified. After excluding factors warranting antibiotic treatment, such as pneumonia, chronic pulmonary obstruction disease (COPD), and immunocompromising conditions, 3616 visits for uncomplicated acute bronchitis remained. Of these, 2244 (62.1%) patients received antibiotic treatment.

 

Rates of prescription were similar across years (P value for trend =0.07). Sex was not associated with prescription in logistic regression analysis (odds ratio [OR] 1.0; 95% CI, 0.9-1.2) nor was race (P =.6). Patients age 18 to 39 years were most frequently prescribed antibiotics (66.9%), followed by those ≥65 years old (59%), and finally the 40- to 64-year age group (58.7%). Macrolides were more likely prescribed to younger adults and fluoroquinolones to older adults (≥65 years old).

Two study limitations were highlighted. First, data may not be representative because it was gathered from private medical clinics visited predominantly by white Americans with private insurance, and the researchers could not account for patient symptoms at the time of visit that influence prescription decisions.

 

Despite the limitations, this study compliments previous findings of overprescription, and researchers concluded that, “these findings highlight the urgent need to reduce inappropriate antibiotic use for bronchitis,” especially in young adults. Because of the high risks in older patients, there is “a need to educate primary care providers on the potential for serious side effects from fluoroquinolone use.”

Disclosures: Drs Grigoryan and Trautner disclose receiving a grant from Zambon Pharmaceuticals.

Reference

Grigoryan L, Zoorob R, Shah J, Wang H, Arya M, Trautner BW. Antibiotic prescribing for uncomplicated acute bronchitis is highest in younger adults. Antibiotics (Basel). 2017;6:22. 

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