The Centers for Disease Control and Prevention has promoted the appropriate use of antibiotics since 1995 when it initiated the National Campaign for Appropriate Antibiotic Use in the Community. This study examined upper respiratory tract infections included in the campaign to determine the degree to which antibiotics were appropriately prescribed and subsequent admission rates in a veteran population. This study was a retrospective chart review conducted among outpatients with a diagnosis of a respiratory tract infection, including bronchitis, pharyngitis, sinusitis, or nonspecific upper respiratory tract infection, between January 2009 and December 2011. The study found that 595 (35.8%) patients were treated appropriately, and 1,067 (64.2%) patients received therapy considered inappropriate based on the Get Smart Campaign criteria. Overall the subsequent readmission rate was 1.5%. The majority (77.5%) of patients were prescribed an antibiotic. The most common antibiotics prescribed were azithromycin (39.0%), amoxicillin-clavulanate (13.2%), and moxifloxacin (
T he Centers for Disease Control and Prevention (CDC) haspromoted the appropriate use of antibiotics since 1995 when it initiated the National Campaign for Appropriate Antibiotic Use in the Community (1). In 2003, this program was renamed Get Smart: Know When Antibiotics Work in conjunction with the launch of a national media campaign. The purpose of this campaign was to curb the rise of antimicrobial resistance, which has been deemed a hazard to public health by groups such as the Institute of Medicine (1, 2). Antibiotic prescribing rates for upper respiratory infections (URIs) alarmingly account for three-quarters of all antibiotic prescriptions written by office-based prescribers (1). There are many different symptoms of respiratory illnesses that bring patients to seek medical attention in the outpatient setting. Cough, congestion, fever, chills, nasal discharge, and sputum production are common symptoms of URIs, most of which are self-limiting and viral in origin (3-6). As part of the Get Smart Campaign, the CDC provides diagnostic criteria and prescribing guidelines for URIs (1).This study examines URIs included in the CDC's Get Smart Campaign to determine the degree to which antibiotics were appropriately prescribed in an outpatient veteran population. It also aims to determine symptoms associated with inappropriate treatment and subsequent admission rates. Other published studies were limited by the use of quantities of antibiotics used but were unable to utilize patient specific data, such as diagnoses and patient visits (7). Bronchitis, pharyngitis, sinusitis, and nonspecific upper respiratory infections were included to determine appropriateness of treatment per the Get Smart Campaign recommendations (8-11).
MATERIALS AND METHODSStudy design. This study was a retrospective chart review conducted among adult patients who had a diagnosis of a respiratory tract infection.Respiratory tract infections were identified by International Classification...
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