ArticleOpen forum infectious diseases2023
Regional Variation in Outpatient Antibiotic Prescribing for Acute Respiratory Tract Infections in a Commercially Insured Population, United States, 2017.
Article in Open forum infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed.
- Are there racial/ethnic differences in antibiotic treatment of community acquired pneumonia in the inpatient setting?PloS one · 2026Article
- Article
- In search of pragmatic measures and models from routinely collected electronic records to inform continuous optimization of antibiotics stewardship at primary care settings: preliminary findings from Anhui, China.BMC infectious diseases · 2025Article
- Appropriateness of ambulatory antibiotic prescribing in South Carolina, 2012-2017.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Predictors of antibiotic prescription for upper respiratory infections in cancer patients.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Macro- and micro-influencers of antimicrobial costs…What do stewardship programs need to know?Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Drivers of district-level differences in outpatient antibiotic prescribing in Germany: a qualitative study with prescribers.BMC health services research · 2024Article
- Decreases and Pronounced Geographic Variability in Antibiotic Prescribing in Medicaid.Pharmacy (Basel, Switzerland) · 2024Article
- Prevalence, regional distribution, and trends of antimicrobial resistance among female outpatients with urine Klebsiella spp. isolates: a multicenter evaluation in the United States between 2011 and 2019.Antimicrobial resistance and infection control · 2024Article
- Implementation of Outpatient Automated Stewardship Information System (OASISAntimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Next Steps in Ambulatory Stewardship.Infectious disease clinics of North America · 2023Review
- "Cultural" Variation in Antibiotic Prescribing: Have Regional Differences Had Their Day?Open forum infectious diseases · 2023Article
- Ecologic analysis of antimicrobial use in South Carolina hospitals during 2020-2022.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Look-Back and Look-Forward Durations and the Apparent Appropriateness of Ambulatory Antibiotic Prescribing.Antibiotics (Basel, Switzerland) · 2022Article
- Outpatient Antibiotic and Antiviral Utilization Patterns in Patients Tested for Respiratory Pathogens in the United States: A Real-World Database Study.Antibiotics (Basel, Switzerland) · 2022Article
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.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Studies have shown that the Southern United States has higher rates of outpatient antibiotic prescribing rates compared with other regions in the country, but the reasons for this variation are unclear. We aimed to determine whether the regional variability in outpatient antibiotic prescribing for respiratory diagnoses can be explained by differences in prescriber clinical factors found in a commercially insured population. Methods: We analyzed the 2017 IBM MarketScan Commercial Database of commercially insured individuals aged <65 years. We included visits with acute respiratory tract infection (ARTI) diagnoses from retail clinics, urgent care centers, emergency departments, and physician offices. ARTI diagnoses were categorized based on antibiotic indication. We calculated risk ratios and 95% CIs stratified by ARTI tier and region using log-binomial models controlling for patient age, comorbidities, care setting, prescriber type, and diagnosis. Results: Of the 14.9 million ARTI visits, 40% received an antibiotic. The South had the highest proportion of visits with an antibiotic prescription (43%), and the West the lowest (34%). ARTI visits in the South are 34% more likely receive an antibiotic for rarely antibiotic-appropriate ARTI visits when compared with the West in multivariable modeling (relative risk, 1.34; 95% CI, 1.33-1.34). Conclusions: It is likely that higher antibiotic prescribing in the South is in part due to nonclinical factors such as regional differences in clinicians' prescribing habits and patient expectations. There is a need for future studies to define and characterize these factors to better inform regional and local stewardship interventions and achieve greater health equity in antibiotic prescribing.
Indexed as
Identifiers
What OpenQuestion holds
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.