Office-related antibiotic prescribing for Medicaid-enrolled children

Abstract

Background: Prudent antibiotic prescribing practices are essential to limiting antibiotic resistance.

Objective: To assess the trend in percentage of office visits for acute respiratory infections (ARIs) linked with an antibiotic prescription.

Methods: Retrospective analysis of Montana Medicaid billing claims data for each year, 1999 to 2010, was done. Participants included continuously enrolled children aged ≤14 years. Primary outcomes were ARI-related office visits and filled antibiotic prescriptions within 10 days of the office visit.

Results: Of the 873 244 office visits identified, 116 962 (13%) had an ARI as the primary diagnosis. Among ARI-related office visits, 64 250 (55%) were linked with an antibiotic prescription. From 1999 to 2010, the odds of ARI-related visits being linked with an antibiotic prescription did not change (odds ratio = 1.00; 95% confidence interval = 0.995-1.002).

Conclusions: The percentage of ARI-related visits linked with an antibiotic prescription did not decrease from 1999 to 2010. Further efforts are needed to reduce antibiotic treatment for ARIs.

Keywords: Medicaid; Montana; antibacterial agents; child; prescriptions; respiratory tract infections.