Antibiotic prescribing in retail clinics, urgent care centers, EDs, and traditional ambulatory care settings

Patients treated in urgent care centers were more likely to be prescribed antibiotics for antibiotic-inappropriate respiratory diagnoses, according to new research. The retrospective cohort study—from CDC's Danielle L.

Patients treated in urgent care centers were more likely to be prescribed antibiotics for antibiotic-inappropriate respiratory diagnoses, according to new research. The retrospective cohort study—from CDC's Danielle L. Palms, MPH, and others—examined antibiotic prescribing among urgent care centers, retail clinics, emergency departments (EDs), and medical offices. Using data from the 2014 Truven Health MarketScan Commercial Claims and Encounters Database, the researchers looked at outpatient claims with facility codes for urgent care center, retail clinic, hospital-based ED, or medical office. "We focused on antibiotic-inappropriate respiratory diagnoses (ie, diagnoses for which antibiotics are unnecessary based on clinical practice guidelines: viral upper respiratory infection, bronchitis/bronchiolitis, asthma/allergy, influenza, nonsuppurative otitis media, and viral pneumonia)," the authors write. The researchers noted wide variation between settings in the percentage of visits during which antibiotics were prescribed. Among 2.7 million urgent care center visits, 39% were linked to antibiotic prescriptions, compared with 36.4% of 58,206 retail clinic visits, 13.8% of 4.8 million ED visits, and 7.1% of 148.5 million medical office visits. When looking at visits for antibiotic-inappropriate respiratory diagnoses, the researchers found that antibiotic prescribing was highest in urgent care centers, at 45.7%, compared with 24.6% in EDs, 17.0% in medical offices, and 14.4% in retail clinics. "These patterns suggest differences in case mix and evidence of antibiotic overuse, especially in urgent care centers. This finding is important because urgent care and retail clinic markets are growing," the researchers report.