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Appropriateness of Outpatient Antibiotic Prescribing

BMJ; ePub 2019 Jan 16; Chua, Fischer, et al

Approximately 1 in 7 privately insured US patients filled at least 1 inappropriate prescription in 2016, a new study found. The cross-sectional study assessed the appropriateness of outpatient antibiotic prescribing for privately insured children and non-elderly adults in the US using a comprehensive classification scheme of diagnosis codes in ICD-10-CM, which replaced ICD-9-CM in the US on October 1, 2015. The study included 19.2 million enrollees aged 0‒64 years. Researchers found:

  • Among all outpatient antibiotic prescription fills by 19,203,264 privately insured US children and non-elderly adults in 2016, 23.2% were inappropriate, 35.5% were potentially appropriate, and 28.5% were not associated with a recent diagnosis code.
  • The most common antibiotics filled by the cohort were azithromycin, amoxicillin, and amoxicillin-clavulanate.
  • Among the inappropriate fills, 70.7% were written in office-based settings, 6.2% in urgent care centers, and 4.7% in emergency departments.


Chua K-P, Fischer MA, Linder JA. Appropriateness of outpatient antibiotic prescribing among privately insured US patients: ICD-10-CM based cross sectional study. [Published online ahead of print January 16, 2019]. BMJ. doi:10.1136/bmj.k5092.