Antibiotic overuse is more prevalent in urgent care clinics than other ambulatory care settings, according to an article published in JAMA Internal Medicine, reported on by Medscape.
Researchers analyzed outpatient claims with facility codes for urgent care center, retail clinic, hospital-based emergency department or medical office. They focused on diagnoses for which antibiotics are unnecessary based on clinical practice guidelines, such as allergies, influenza or the common cold.
The study was conducted as part of a collaboration between the CDC and the Pew Charitable Trusts.
Here are five insights:
1. Sixteen percent of visits at urgent care centers involved antibiotic-inappropriate respiratory diagnoses. Among those patients, 45.7 percent received an antibiotic prescription.
2. By comparison, 24.6 percent of patients treated in an emergency department, 17 percent in medical offices and 14.4 percent in retail clinics were prescribed antibiotics inappropriately.
3. Patients with respiratory diagnoses not requiring antibiotics comprised a greater proportion of visits at retail and urgent care clinics than at other ambulatory settings. The percentage of visits involving antibiotic-inappropriate respiratory diagnoses was 17 percent for retail clinic visits, 6 percent for medical offices and 5 percent for EDs.
4. Antibiotic prescriptions for upper respiratory tract conditions were two to three times higher at urgent care centers than at other outpatient sites.
5. The study didn't investigate factors behind the prescribing patterns seen in urgent care centers and retail clinics. However, other studies show outpatient providers are significantly influenced by patient pressure and demand when prescribing antibiotics, David Hyun, MD, of the Pew Charitable Trusts, told Medscape Medical News.
"Our study underscores the need for antibiotic stewardship in all outpatient settings where antibiotics are being prescribed, including both urgent care centers and retail clinics, and that there is room for improvement across the board," said Dr. Hyun.
