ArticleInfection control and hospital epidemiology2022
Development and validation of antibiotic stewardship metrics for outpatient respiratory tract diagnoses and association of provider characteristics with inappropriate prescribing.
Article in Infection control and hospital epidemiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Early-career general practitioners' antibiotic prescribing for acute infections: a systematic review.The Journal of antimicrobial chemotherapy · 2024Pooled it
- Improving Outpatient Antibiotic Prescribing for Respiratory Tract Infections in Primary Care: A Stepped-Wedge Cluster Randomized Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Trial
- The changing landscape of outpatient antibiotic prescriptions among advanced practice clinicians in the United States, 2011 and 2022.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- The influence of social relationships on clinician interpretation of performance data in an outpatient antibiotic stewardship intervention.Antimicrobial resistance and infection control · 2025Article
- Article
- Utilisation of antibiotics in a community pharmacy: A case from north-west, South Africa.African journal of primary health care & family medicine · 2025Article
- Healthcare worker views on antimicrobial resistance in chronic respiratory disease.Antimicrobial resistance and infection control · 2025Article
- Appropriateness of intended antibiotic prescribing using clinical case vignettes in primary care, and related factors.The European journal of general practice · 2024Article
- Influencing Primary Care Antibiotic Prescription Behavior Using Financial Incentives.Production and operations management · 2024Article
- Evaluation of appropriateness of antibiotic prescribing in primary healthcare institutions in China using proxy indicator.The Lancet regional health. Western Pacific · 2024Article
- Antibiotic Prescribing Patterns for Respiratory Tract Illnesses Following the Conclusion of an Education and Feedback Intervention in Primary Care.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Teams in Transition: Increasing Role of Advanced Practice Providers in Antimicrobial Use and Infectious Diseases Consultation.Open forum infectious diseases · 2024Article
- "Electronic Phenotyping" Antimicrobials to Facilitate Outpatient Stewardship for Asymptomatic Bacteriuria and Urinary Tract Infection in Renal Transplant.Open forum infectious diseases · 2024Article
- Adaptation and validation of an antibiotic prescribing, peer comparison metric for respiratory tract diagnoses in walk-in clinics: a mixed-methods analysis.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Validity of Coronavirus Disease 2019Open forum infectious diseases · 2023Article
- Analysis of seasonal variation of antibiotic prescribing for respiratory tract diagnoses in primary care practices.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo determine metrics and provider characteristics associated with inappropriate antibiotic prescribing for respiratory tract diagnoses (RTDs).
designRetrospective cohort study.
settingPrimary care practices in a university health system.
participantsPatients seen by an attending physician or advanced practice provider (APP) at their primary care office visit with International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM)-coded RTDs.
methodsMedical records were reviewed for 1,200 randomly selected office visits in which an antibiotic was prescribed to determine appropriateness. Based on this gold standard, metrics and provider characteristics associated with inappropriate antibiotic prescribing were determined.
resultsOverall, 69% of antibiotics were inappropriate. Metrics utilizing prespecified RTDs most strongly associated with inappropriate prescribing were (1) proportion prescribing for RTDs for which antibiotics are almost never required (eg, bronchitis) and (2) proportion prescribing for any RTD. Provider characteristics associated with inappropriate antibiotic prescribing were APP versus physician (72% vs 58%; P = .02), family medicine versus internal medicine (76% vs 63%; P = .01), board certification 1997 or later versus board certification before 1997 (75% vs 63%; P = .02), nonteaching versus teaching practice (73% vs 51%; P < .01), and nonurban vs urban practice (77% vs 57%; P < .01).
conclusionsMetrics utilizing proportion prescribing for RTDs for which antibiotics are almost never required and proportion prescribing for any RTD were most strongly associated with inappropriate prescribing. APPs and clinicians with family medicine training, with board certification 1997 or later, and who worked in nonteaching or nonurban practices had higher proportions of inappropriate prescribing. These findings could inform design of interventions to improve prescribing and could represent an efficient way to track inappropriate prescribing.
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Registered trials
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