ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Late-career Physicians Prescribe Longer Courses of Antibiotics.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 68 citations in OpenAlex.
- Early-career general practitioners' antibiotic prescribing for acute infections: a systematic review.The Journal of antimicrobial chemotherapy · 2024Pooled it
- Burden of Clostridioides difficile infection (CDI) - a systematic review of the epidemiology of primary and recurrent CDI.BMC infectious diseases · 2021Pooled it
- Self-reported acceptability and feasibility of a multimodal intervention to reduce antibiotic prescriptions for urinary tract infections in primary care: a process evaluation of the RedAres trial among general practitioners and medical practice assistants.BMC health services research · 2025Trial
- Residency Competency Assessments and Early-Career Primary Care Physicians' Antibiotic Prescribing.JAMA network open · 2026Article
- Packaged intervention targeting oral antimicrobials in Japanese tertiary care outpatient setting: a quasi-experimental study.JAC-antimicrobial resistance · 2026Article
- Practice guideline on the prevention and treatment of central line-associated bloodstream infection: Part 2 - Treatment.Journal of intensive medicine · 2026Article
- Antibiotic prescribing trends among Belgian dentists (2014-2023) and the impact of the COVID-19 pandemic.Archives of public health = Archives belges de sante publique · 2026Article
- Evaluation of Short Versus Long Courses of Antibiotics in Critically Ill Patients With Gram-Negative Bloodstream Infections.The Annals of pharmacotherapy · 2024Article
- Opportunities to Improve Antibiotic Prescribing for Adults With Acute Sinusitis, United States, 2016-2020.Open forum infectious diseases · 2024Article
- Antimicrobial Prescription Behavior in Equine Asthma Cases: An International Survey.Animals : an open access journal from MDPI · 2024Article
- Factors Associated with Geographical Variability of Antimicrobial Use in Japan.Infectious diseases and therapy · 2023Article
- Antibiotic Prescription for Outpatients With COVID-19 in Primary Care Settings in Japan.JAMA network open · 2023Article
- Examining antibiotic prescribing and urine culture testing for urinary tract infections (UTIs) in a primary care spinal cord injury (SCI) cohort.Spinal cord · 2023Article
- Identifying Patterns of Primary Care Antibiotic Prescribing for a Spinal Cord Injury (SCI) Cohort Using an Electronic Medical Records (EMR) Database.Topics in spinal cord injury rehabilitation · 2023Article
- Can the Future of ID Escape the Inertial Dogma of Its Past? The Exemplars of Shorter Is Better and Oral Is the New IV.Open forum infectious diseases · 2023Article
- Infectious disease physician characteristics and prescription of meropenem in the hospital.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Variability in changes in physician outpatient antibiotic prescribing from 2019 to 2021 during the COVID-19 pandemic in Ontario, Canada.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Factors Associated With Acceptance of Telehealth-Based Antimicrobial Stewardship Program Recommendations in a Community Hospital Health System.Open forum infectious diseases · 2022Article
- Private Practice Dentists Improve Antibiotic Use After Dental Antibiotic Stewardship Education From Infectious Diseases Experts.Open forum infectious diseases · 2022Article
- Coping with 'the grey area' of antibiotic prescribing: a theory-informed qualitative study exploring family physician perspectives on antibiotic prescribing.BMC primary care · 2022Article
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Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntibiotic duration is often longer than necessary. Understanding the reasons for variability in antibiotic duration can inform interventions to reduce prolonged antibiotic use. We aim to describe patterns of interphysician variability in prescribed antibiotic treatment durations and determine physician predictors of prolonged antibiotic duration in the community setting.
methodsWe performed a retrospective cohort analysis of family physicians in Ontario, Canada, between 1 March 2016 and 28 February 2017, using the Xponent dataset from IQVIA. The primary outcome was proportion of prolonged antibiotic course prescribed, defined as >8 days of therapy. We used multivariable logistic regression models, with generalized estimating equations to account for physician-level clustering to evaluate predictors of prolonged antibiotic courses.
resultsThere were 10 616 family physicians included in the study, prescribing 5.6 million antibiotic courses. There was substantial interphysician variability in the proportion of prolonged antibiotic courses (median, 33.3%; interdecile range, 13.5%-60.3%). In the multivariable regression model, later physician career stage, rural location, and a larger pediatric practice were significantly associated with greater use of prolonged courses. Prolonged courses were more likely to be prescribed by late-career physicians (adjusted odds ratio [aOR], 1.48; 95% confidence interval, 1.38-1.58) and mid-career physicians (aOR, 1.25; 1.16-1.34) when compared to early-career physicians.
conclusionsWe observed substantial variability in prescribed antibiotic duration across family physicians, with durations particularly long among late-career physicians. These findings highlight opportunities for community antimicrobial stewardship interventions to improve antibiotic use by addressing practice differences in later-career physicians.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.