Buffalo, NY—A new study on antibiotic prescriptions for acute respiratory tract infections (ARIs) in the outpatient setting included both good news and bad news.

The report in BMC Family Practice found that although use of antibiotics for ARIs, which are predominantly viral and usually don’t benefit from those drugs, is declining, it still remains high, according to University at Buffalo–led researchers.

The study used the U.S. Medical Expenditure Panel Survey (MEPS; 2010-2015) to estimate the national prevalence and predictors of outpatient antibiotic prescribing for ARIs by provider type. Essentially, the study team looked at whether the antibiotics were broad-spectrum and whether a physician or advanced-practice provider, such as a nurse practitioner or physician assistant, prescribed them.

Researchers report that, while about 64.1 million antibiotic prescriptions were written over the 5-year study period, the annual number decreased from 10.9 million in 2010 to 9.7 million in 2015.

“Antibiotic prescribing for ARIs though declining, remains high,” study authors emphasize. “More research is needed to better understand the drivers of ARI antibiotic prescribing and to develop targeted interventions for both patients and providers.”

The study team used binary logistic regression to determine associations of patient- and provider-level variables with prescribing of antibiotics. Results indicate that blacks were more likely to receive antibiotics than whites (OR 1.51; 95% CI, 1.25, 1.84; P <.001), and antibiotic prescription was more likely if the race of the patient and provider was concordant (OR 5.41; 95% CI, 4.65, 6.29, P <.0001).

During the time of the study, the authors note that the majority of patients with ARI were cared for by physicians, but they point out that APPs are seeing an increasing number of ARI patients.

“In conclusion, ARI antibiotic prescribing has decreased over the study period namely in the final year of the study,” the researchers point out. “Though it is possible the difference seen in prescribing may not be a true reduction, only future study will tell if there are other factors at work that could have accounted for the differences observed.”

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