ArticlePloS one2024
Ambulatory antibiotic prescription rates for acute respiratory infection rebound two years after the start of the COVID-19 pandemic.
Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Barriers and Enablers for Sustaining Nurse-Led Use of Clinical Decision Support Tools for Antibiotic Stewardship: Qualitative Study.JMIR nursing · 2026Article
- Antibiotic utilization pattern and its associated factors based on WHO AWaRe classification at a university hospital in the South of Thailand.Journal of pharmaceutical policy and practice · 2026Article
- [Grades of Antibiotic Prescription Rates for Acute Upper and Lower Respiratory Tract Infections in the Republic of Korea in 2023 and Trends in Grade Changes from 2020 to 2023].Jugan geon-gang gwa jilbyeong · 2025Article
- Increase in Antibiotic Utilisation in Primary Care Post COVID-19 Pandemic.Antibiotics (Basel, Switzerland) · 2025Article
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Authors and funding
13 authors.
Funding
Abstract
backgroundDuring the COVID-19 pandemic, acute respiratory infection (ARI) antibiotic prescribing in ambulatory care markedly decreased. It is unclear if antibiotic prescription rates will remain lowered.
methodsWe used trend analyses of antibiotics prescribed during and after the first wave of COVID-19 to determine whether ARI antibiotic prescribing rates in ambulatory care have remained suppressed compared to pre-COVID-19 levels. Retrospective data was used from patients with ARI or UTI diagnosis code(s) for their encounter from 298 primary care and 66 urgent care practices within four academic health systems in New York, Wisconsin, and Utah between January 2017 and June 2022. The primary measures included antibiotic prescriptions per 100 non-COVID ARI encounters, encounter volume, prescribing trends, and change from expected trend.
resultsAt baseline, during and after the first wave, the overall ARI antibiotic prescribing rates were 54.7, 38.5, and 54.7 prescriptions per 100 encounters, respectively. ARI antibiotic prescription rates saw a statistically significant decline after COVID-19 onset (step change -15.2, 95% CI: -19.6 to -4.8). During the first wave, encounter volume decreased 29.4% and, after the first wave, remained decreased by 188%. After the first wave, ARI antibiotic prescription rates were no longer significantly suppressed from baseline (step change 0.01, 95% CI: -6.3 to 6.2). There was no significant difference between UTI antibiotic prescription rates at baseline versus the end of the observation period.
conclusionsThe decline in ARI antibiotic prescribing observed after the onset of COVID-19 was temporary, not mirrored in UTI antibiotic prescribing, and does not represent a long-term change in clinician prescribing behaviors. During a period of heightened awareness of a viral cause of ARI, a substantial and clinically meaningful decrease in clinician antibiotic prescribing was observed. Future efforts in antibiotic stewardship may benefit from continued study of factors leading to this reduction and rebound in prescribing rates.
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