Antibiotics

Advanced practitioners more likely to prescribe inappropriate antibiotics than doctors

Research shows that when treating adult patients, advanced practitioners, such as nurse prescribers, were 15% more likely to prescribe an antibiotic than doctors.

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Source: Mark Thomas / Science Photo Library

Researchers studied data on 448,990 outpatient visits for common upper respiratory conditions for which antibiotics are not recommended

A study has shown that advanced practitioners are more likely to prescribe inappropriate antibiotics than doctors.

Researchers studied data on 448,990 outpatient visits for common upper respiratory conditions for which antibiotics are not recommended, such as acute bronchitis, bronchiolitis, nonsuppurative otitis media and viral upper respiratory infection.

The team found that acute bronchitis was the most common indication for which antibiotics were prescribed across all settings, and that patients were more likely to receive an antibiotic with increasing age.

When treating adult patients, advanced practitioners, such as nurse prescribers, were 15% more likely to prescribe an antibiotic than doctors, while in paediatric patients, older providers were four times more likely to prescribe an antibiotic than those aged 30 years and under.

Writing in Infection Control & Hospital Epidemiology (online, 30 January 2018), the authors said that these results should provide useful information to tailor outpatient antibiotic stewardship interventions to specific provider and patient populations[1].

Citation: Clinical Pharmacist DOI: 10.1211/CP.2018.20204614

Readers' comments (1)

  • It's worth noting that this study has a number of factors that should be considered before applying to UK practice:
    1. This is a study in a US healthcare setting.
    2. It's a retrospective study, and assumes that the antibiotic prescribed, relates to the indication coded in the patient record.
    3. There are a number of factors identified in this study linked to higher than average antibiotic prescribing:
    a. HCPs aged between 51 and 60 were 400% more likely to prescribe an antibiotic than HCPs aged <30. Race/ethnicity affected how likely patients were to be prescribed an antibiotic. Insurance/funding route affected how likely patients were to be prescribed an antibiotic: the authors note they need a better understanding of the impact of socio-economic factors in relation to variation in prescribing. There doesn't appear to be any direct comparison of the patient sub-groups that HCPs saw. Did non-medical prescribers see a more complex or different cohort of patients? This is not clearly analysed or discussed in the study.

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