Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Oct 22;63(11):e01060-19.
doi: 10.1128/AAC.01060-19. Print 2019 Nov.

First-Line Antibiotic Selection in Outpatient Settings

Danielle L Palms  1 , Lauri A Hicks  1 , Monina Bartoces  1 , Adam L Hersh  2 , Rachel Zetts  3 , David Y Hyun  3 , Katherine E Fleming-Dutra  4
Affiliations

First-Line Antibiotic Selection in Outpatient Settings

Danielle L Palms et al. Antimicrob Agents Chemother. .

Abstract

Using the 2014 IBM MarketScan commercial database, we compared antibiotic selection for pharyngitis, sinusitis, and acute otitis media in retail clinics, emergency departments, urgent care centers, and offices. Only 50% of visits for these conditions received recommended first-line antibiotics. Improving antibiotic selection for common outpatient conditions is an important stewardship target.

Keywords: acute otitis media; antibiotic stewardship; outpatient; pharyngitis; sinusitis.

PubMed Disclaimer

Figures

FIG 1
FIG 1
First-line antibiotic selection for pharyngitis, sinusitis, and pediatric AOM, according to age, across settings in 2014. Pediatric visits included pediatric pharyngitis, sinusitis, and AOM visits that received an antibiotic. Adult visits included adult pharyngitis and sinusitis visits that received an antibiotic. First-line therapy included amoxicillin or penicillin for pharyngitis and amoxicillin or amoxicillin-clavulanate for sinusitis and AOM. Non-first-line therapy included all other antibiotics.
See this image and copyright information in PMC

References

    1. Sanchez G, Fleming-Dutra K, Roberts R, Hicks L. 2016. Core elements of outpatient antibiotic stewardship. MMWR Recomm Rep 65:1–12. doi:10.15585/mmwr.rr6506a1. - DOI - PubMed
    1. Hersh AL, Fleming-Dutra KE, Shapiro DJ, Hyun DY, Hicks LA. 2016. Frequency of first-line antibiotic selection among US ambulatory care visits for otitis media, sinusitis, and pharyngitis. JAMA Intern Med 176:1870–1872. doi:10.1001/jamainternmed.2016.6625. - DOI - PMC - PubMed
    1. Palms DL, Hicks LA, Bartoces M, Hersh AL, Zetts R, Hyun DY, Fleming-Dutra KE. 2018. Comparison of antibiotic prescribing in retail clinics, urgent care centers, emergency departments, and traditional ambulatory care settings in the United States. JAMA Intern Med 178:1267–1269. doi:10.1001/jamainternmed.2018.1632. - DOI - PMC - PubMed
    1. Fleming-Dutra KE, Hersh AL, Shapiro DJ, Bartoces M, Enns EA, File TM Jr, Finkelstein JA, Gerber JS, Hyun DY, Linder JA, Lynfield R, Margolis DJ, May LS, Merenstein D, Metlay JP, Newland JG, Piccirillo JF, Roberts RM, Sanchez GV, Suda KJ, Thomas A, Woo TM, Zetts RM, Hicks LA. 2016. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010–2011. JAMA 315:1864–1873. doi:10.1001/jama.2016.4151. - DOI - PubMed
    1. Piccirillo JF, Mager DE, Frisse ME, Brophy RH, Goggin A. 2001. Impact of first-line vs second-line antibiotics for the treatment of acute uncomplicated sinusitis. JAMA 286:1849–1856. doi:10.1001/jama.286.15.1849. - DOI - PubMed

Publication types

Substances