Nurse practitioners (NP) and physician assistants (PA) were more likely to prescribe antibiotics during ambulatory care visits compared to visits with physicians only, according to a study published in Open Forum Infectious Diseases. 

Guillermo V. Sanchez, MPH, and his colleagues from the Centers for Disease Control and Prevention (CDC) analyzed prescribing data related to respiratory tract infections as well as overall visits gathered between 2006 and 2011 from the National Ambulatory Medical Care and the National Hospital Ambulatory Medical Care surveys. 

The CDC researchers saw a doubling in the number of visits involving NPs and PAs during the study period. They noted that NPs and PAs were more likely to prescribe antibiotics for acute respiratory tract infections than physician only visits (61% vs. 54%, p <.001); this trend was also noted for overall visits, at 17% for visits involving NPs and PAs compared with 12% for doctor-only visits. 

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The researchers noted some limitations to their study, specifically that the “the sampling methods were designed to produce estimates that are representative of visits to office-based and emergency department physicians and may not be representative of NP and PA practices in these settings.”

Regardless of this limitation, the researchers noted that their findings showed antibiotic prescription rates were “much higher than desired and necessary, mandating ongoing evaluation and intervention to minimize antibiotic resistance, adverse drug events, and poor clinical outcomes which result from inappropriate antibiotic prescribing.”  


1. Sanchez GV, Hersh AL, Shapiro DJ, et al. Outpatient antibiotic prescribing among US nurse practitioners and physician assistants. Open Forum Infect Dis. 2016;doi: 10.1093/ofid/ofw168.