Antibiotic prescription pattern for viral respiratory illness in emergency room and ambulatory care settings

Objective: To evaluate the current practice pattern of antibiotic prescription rate in viral respiratory tract infection diagnosed children among different specialty health care providers. Methods: The study was a retrospective case review study where a random sample of 1200 child care visits coded as viral respiratory infections in primary care provider's office, convenient care clinic, or emergency room in 2006 were analyzed. Results: Overall, the antibiotic prescription rate was 30%. The prescription rate was 3.7 times (95% confidence interval [CI] = 1.90-7.31) higher for bronchitis patients and 2.5 times (95% CI = 1.46-4.30) higher for viral pharyngitis patients than for common cold patients. Antibiotics were written more by emergency physicians (odds ratio [OR] = 11.04; 95% CI = 5.78-21.10) and family practitioners (OR = 5.22; 95% CI = 2.99-9.10) than by pediatricians. Conclusion: Although not recommended, children seen in the emergency room and family practitioner's office are more likely to receive antibiotic prescriptions than those seen in the pediatrician's office.