Antibiotic prescribing for acute gastroenteritis during ambulatory care visits—United States, 2006–2015

• DOI: 10.1017/ice.2021.522
• Publication Date: 2022-08-26T09:03:28Z
• Authors: Jennifer P. Collins; Laura M. King; Sarah A. Collier; John Person; Megan E. Gerdes; Stacy M. Crim; Monina Bartoces; Katherine E. Flem...; Cindy R. Friedman; Louise K. Francoi...
• Keywords: Emergency Service; 610; Practice Patterns; United States; Anti-Bacterial Agents; Gastroenteritis; 3. Good health; Hospital; 03 medical and health sciences; 0302 clinical medicine; Physicians; Health Care Surveys; 616; Ambulatory Care; Humans; Original Article; Practice Patterns, Physicians'; Emergency Service, Hospital

Abstract Objective: To describe national antibiotic prescribing for acute gastroenteritis (AGE). Setting: Ambulatory care. Methods: We included visits with diagnoses bacterial and viral gastrointestinal infections from the National Medical Care Survey Hospital (NAMCS/NHAMCS; 2006–2015) IBM Watson 2014 MarketScan Commercial Claims Encounters Database. For NAMCS/NHAMCS, we calculated annual percentage estimates 99% confidence intervals (CIs) of antibiotics prescribed; sample sizes were too small to calculate by pathogen. MarketScan, used Poisson regression prescribed 95% CIs, including Results: 10,210 NAMCS/NHAMCS AGE visits; an estimated 13.3% (99% CI, 11.2%–15.4%) resulted in prescriptions, most frequently fluoroquinolones (28.7%; 21.1%–36.3%), nitroimidazoles (20.2%; 14.0%–26.4%), penicillins (18.9%; 11.6%–26.2%). In was least frequent emergency departments (10.8%; 9.5%–12.1%). Among 1,868,465 visits, 13.8% (95% 13.7%−13.8%), commonly Yersinia (46.7%; 21.4%–71.9%), Campylobacter (44.8%; 41.5%–48.1%), Shigella (39.7%; 35.9%–43.6%), typhoid or paratyphoid fever (32.7%; 27.2%–38.3%), nontyphoidal Salmonella (31.7%; 29.5%–33.9%). Antibiotics 12.3% 11.7%–13.0%) gastroenteritis. Conclusions: Overall, ∼13% prescriptions. unnecessarily some which are not recommended. Antibiotic stewardship assessments interventions needed ambulatory settings.