Overprescription of Antibiotics for Acute Respiratory Infections

Investigators from multiple institutions conducted a cohort study to characterize antibiotic prescribing among outpatients with acute respiratory infections during influenza season. Patients receiving care at 1 of 123 outpatient clinics associated with the 5 US Influenza Vaccine Effectiveness Network sites were eligible. Patients who were ≥6 months old and had an acute respiratory infection (defined as a new cough of ≤7 days’ duration) were included. Patient demographics and a respiratory swab for influenza were obtained at enrollment. Influenza swab results were not available to clinicians at 4 of the 5 network sites.

The primary exposure was patient diagnosis, determined using ICD-9 codes from the medical encounter. Diagnosis codes were classified as Tier 1, which included diagnoses for which antibiotics were almost always indicated …