Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Variability in Antibiotic Prescribing for ARIs

Open Forum Infect Dis; ePub 2019 Jan 18; Jung, et al

Antibiotic prescribing for acute respiratory infections (ARIs) is higher than expected based on prescribing guidelines, with variation in prescribing rates by site and provider. This according to a cross-sectional study of patients who presented with an ARI to any of 15 The Emory Clinic (TEC) primary care clinic sites between October 2015 and September 2017. Researchers examined the impact of patient, provider, and clinic characteristics on antibiotic prescribing. They found:

  • 53.4% of the 9,600 patient encounters with a diagnosis of ARI resulted in an antibiotic prescription.
  • The odds of an encounter resulting in an antibiotic prescription were independently associated with patient characteristics of white race, older age, and comorbid condition presence.
  • Of the 109 providers, 13 (12%) had a rate significantly higher than predicted by modeling.


Jung S, Sexton ME, Owens S, Spell N, Fridkin S. Variability of antibiotic prescribing in a large healthcare network despite adjusting for patient-mix: Reconsidering targets for improved prescribing. [Published online ahead of print January 18, 2019]. Open Forum Infect Dis. doi:10.1093/ofid/ofz018.

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