Ambulatory antibiotic prescription rates for acute respiratory infection rebound two years after the start of the COVID-19 pandemic
Elizabeth R. Stevens, David Feldstein, Simon Jones, Chelsea Twan, Xingwei Cui, Rachel Hess, Eun Ji Kim, Safiya Richardson, Fatima M. Malik, Sumaiya Tasneem, Natalie Henning, Lynn Xu, Devin M. Mann
Abstract
During 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.
Introduction
For decades antibiotic prescribing rates in the United States have remained persistently high. Despite efforts to educate patients and clinicians regarding the ineffectiveness of antibiotics in most acute respiratory infections (ARIs).
Materials and Methods
Ambulatory care data was retrospectively collected from the electronic health records (EHR) of four large academic health care systems in New York (two sites, henceforth referred to as NY-A and NY-B), Utah, and Wisconsin between the period of January 1, 2017 and June 30, 2022 (December 31, 2021 for NY-B and Wisconsin)
Result
ARI antibiotic prescribing rates and trend over time are presented by site in Fig 1a–1d and in aggregate in Fig 2a. Slope and step change data for each study site can be found in Table 1.
Discussion
This research represents one of the first multisite studies examining antibiotic prescribing trends for ARI in ambulatory care settings more than one year after the onset of the COVID-19 pandemic and the initial observed decline in ARI antibiotic prescribing.
Conclusion
The decline in antibiotic prescribing for ARI observed after the onset of the COVID-19 pandemic was temporary and does not represent a long-term change in clinician prescribing behaviors.
Citation: Stevens ER, Feldstein D, Jones S, Twan C, Cui X, Hess R, et al. (2024) Ambulatory antibiotic prescription rates for acute respiratory infection rebound two years after the start of the COVID-19 pandemic. PLoS ONE 19(6): e0306195. https://doi.org/10.1371/journal.pone.0306195
Editor: Shinya Tsuzuki, National Center for Global Health and Medicine, JAPAN
Received: October 2, 2023; Accepted: June 5, 2024; Published: June 25, 2024
Copyright: © 2024 Stevens et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: Data is available upon reasonable request. Data cannot be shared publicly as it contains potentially identifying and sensitive patient information and is protected by institutional data access restrictions. Data is available for researchers who meet the criteria for access to confidential data with execution of a data use agreement with each of the participating institutions. These restrictions are imposed by the Institutional Review Boards of the four participating institutions and data can be accessed through a data sharing agreement executed with each separate institution. The contact information to access the data from the IRBs include NYU IRB-Info@NYULangone.org; Utah IRB@hsc.utah.edu; Wisconsin AskTheIRB@hsirb.wisc.edu; and Northwell irb@northwell.edu.
Funding: NIAID (Mann - 5R01AI108680) (https://www.niaid.nih.gov/) The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Feldstein - University of Wisconsin Institute for Clinical and Translational Research through the Clinical and Translational Science Award (CTSA) UL1TR002373 (NCATS/NIH) https://ncats.nih.gov/ctsa The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Source: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0306195#abstract0
