+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Antibiotic Prescribing by Physicians Versus Nurse Practitioners for Pediatric Upper Respiratory Infections



Antibiotic Prescribing by Physicians Versus Nurse Practitioners for Pediatric Upper Respiratory Infections



Annals of Otology Rhinology and Laryngology 125(12): 982-991



This study investigates differences in antibiotic prescribing rates for pediatric upper respiratory infections (URIs) between physicians and nurse practitioners (NPs). Visits by children <18 years old diagnosed with URI to physicians or NPs between 2001 and 2010 were abstracted from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Care Survey. Logistic regression analyses examined variations in antibiotic prescribing rates. Upper respiratory infections accounted for approximately 439 ± 21.5 million visits. Patients seen by NPs were more likely to have Medicaid, live in the lowest median household income quartile zip codes and micropolitan locations, and live in the South compared to patients seen by physicians. Nurse practitioners prescribed antibiotics 66.7% ± 4.2% of the time versus physicians at 52.8% ± 0.8% for URI visits (unadjusted P-value = .002). Adjusted by specialty, URI type, and chronic diseases, NPs had marginally significantly different odds of prescribing antibiotics (OR = 1.6, 95% CI, 1.0-2.6, P-value = .048), but the association with prescribing broad-spectrum antibiotics is not as strong (adjusted P-value = .063). Patient visits to a pediatric (OR = 0.54, 95% CI, 0.43-0.67) or ENT/surgery practice (OR = 0.11, 95% CI, 0.06-0.18) had lower odds of antibiotic prescribing compared to general/family medicine practices. Year (2001-2010) was not significantly associated with antibiotic or broad-spectrum antibiotic prescribing rates for physicians, but rates for NPs fell for otitis media (P-value = .007) from 90.2% ± 8.2% (2001-2002) to 74.8% ± 6.8% (2009-2010) of visits. Nurse practitioners have higher rates of antibiotic prescribing compared to physicians for pediatric patients with URIs; however, this difference is less after adjusting for specialty. Examining comparative antibiotic prescribing is important to promote evidence-based practice and adoption of clinical guidelines.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 057209296

Download citation: RISBibTeXText

PMID: 27707916

DOI: 10.1177/0003489416668193


Related references

Physicians' antibiotic prescribing habits for upper respiratory tract infections in Turkey. Journal of ChemoTherapy 14(2): 181-184, 2002

Antibiotic prescribing by primary care physicians for children with upper respiratory tract infections. Archives of Pediatrics & Adolescent Medicine 156(11): 1114-1119, 2002

Pattern of upper respiratory tract infections and physicians' antibiotic prescribing practices in Bahrain. Medical Principles and Practice 18(3): 170-174, 2009

Enabling factors for antibiotic prescribing for upper respiratory tract infections: perspectives of Lithuanian and Russian general practitioners. Upsala Journal of Medical Sciences 118(2): 98, 2013

Antibiotic prescribing for colds, upper respiratory infections and bronchitis by ambulatory physicians in the United States. Jgim 12(Suppl 1): 72, 1997

Antibiotic prescribing for adults with colds, upper respiratory tract infections, and bronchitis by ambulatory care physicians. Jama (journal Of The American Medical Association). 278(11): 901-904, 1997

Osteopathic physicians in the United States: antibiotic prescribing practices for patients with nonspecific upper respiratory tract infections. Journal of the American Osteopathic Association 106(8): 450-455, 2006

Antibiotic prescribing habits of nurse practitioners treating pediatric patients: AntiBUGS pediatrics. Journal of the American Academy of Nurse Practitioners 19(6): 332-334, 2007

Antibiotic Prescriptions for Upper Respiratory Infections in a Pediatric Office Versus an Urgent Care Center. Global Pediatric Health 6: 2333794x19835632, 2019

Respiratory infections for which general practitioners consider prescribing an antibiotic: a prospective study. Archives of Disease in Childhood 92(7): 594-597, 2007

Impact of an Educational Intervention to Improve Antibiotic Prescribing for Nurse Practitioners in a Pediatric Urgent Care Center. Journal of Pediatric Health Care 31(2): 184-188, 2016

Effect of a training and educational intervention for physicians and caregivers on antibiotic prescribing for upper respiratory tract infections in children at primary care facilities in rural China: a cluster-randomised controlled trial. Lancet. Global Health 5(12): E1258-E1267, 2017

Changes in clinical indications for community antibiotic prescribing for children in the UK from 1996 to 2006: will the new NICE prescribing guidance on upper respiratory tract infections just be ignored?. Archives of Disease in Childhood 94(5): 337-340, 2009

Inappropriate antibiotic prescribing and demand for antibiotics in patients with upper respiratory tract infections is hardly different in female versus male patients as seen in primary care. European Journal of General Practice 21(2): 118-123, 2015

Use of point-of-care tests and antibiotic prescribing in sore throat and lower respiratory infections by general practitioners. Enfermedades Infecciosas Y Microbiologia Clinica 2019:, 2019