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Analysis of Prescribing Practices for Upper Respiratory Tract Infections by Western Montana Cinic Providers from May 2003 - April 2004

1 August 2004


Context: The overuse of antibiotics to treat Upper Respiratory Infections (URIs) is a common problem in health care which has implications for both individual patients and community-wide antimicrobial resistance. Proper diagnosis and treatment of acute rhinobacterial sinusitis (ARBS) and Viral Upper Respiratory Infection"s (VURI) is important to ensure long-term public health.

Design: This study is a retrospective chart review of333 randomly selected primary care charts from May 2003 to April 2004 with visit diagnoses with ICD9 codes 465.9 (URI! Nasopharyngitis), 461.9 (sinusitis), 473.9 (chronic sinusitis), 477.9 (allergic rhinitis), 460 (acute nasopharyngitis), 490 (bronchitis), and 786.2 (cough). Diagnoses were compared to established criteria for acute rhino bacterial sinusitis, and the use of antibiotics was examined. Data was compared to two previous years to determine the success of a recent educational initiative on judicious antibiotic prescribing.

Results: Rates of antibiotic use were significantly less in this year's study compared to previous years. Most notably, in the category of patients with non-sinusitis diagnoses, 17% received antibiotics in 2004 compared to 46% in 2002 and 62% in 2001 (Chi Squared, p

Conclusion: Antibiotic prescribing for non ARBS diagnoses decreased significantly. The recent educational effort likely contributed to the improved prescribing trends, and " represents an important method for decreasing inappropriate antibiotic use in upper respiratory tract infections.


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