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Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011

Overview of attention for article published in JAMA: Journal of the American Medical Association, May 2016
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (99th percentile)

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Title
Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011
Published in
JAMA: Journal of the American Medical Association, May 2016
DOI 10.1001/jama.2016.4151
Pubmed ID
Authors

Katherine E. Fleming-Dutra, Adam L. Hersh, Daniel J. Shapiro, Monina Bartoces, Eva A. Enns, Thomas M. File, Jonathan A. Finkelstein, Jeffrey S. Gerber, David Y. Hyun, Jeffrey A. Linder, Ruth Lynfield, David J. Margolis, Larissa S. May, Daniel Merenstein, Joshua P. Metlay, Jason G. Newland, Jay F. Piccirillo, Rebecca M. Roberts, Guillermo V. Sanchez, Katie J. Suda, Ann Thomas, Teri Moser Woo, Rachel M. Zetts, Lauri A. Hicks

Abstract

The National Action Plan for Combating Antibiotic-Resistant Bacteria set a goal of reducing inappropriate outpatient antibiotic use by 50% by 2020, but the extent of inappropriate outpatient antibiotic use is unknown. To estimate the rates of outpatient oral antibiotic prescribing by age and diagnosis, and the estimated portions of antibiotic use that may be inappropriate in adults and children in the United States. Using the 2010-2011 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, annual numbers and population-adjusted rates with 95% confidence intervals of ambulatory visits with oral antibiotic prescriptions by age, region, and diagnosis in the United States were estimated. Ambulatory care visits. Based on national guidelines and regional variation in prescribing, diagnosis-specific prevalence and rates of total and appropriate antibiotic prescriptions were determined. These rates were combined to calculate an estimate of the appropriate annual rate of antibiotic prescriptions per 1000 population. Of the 184 032 sampled visits, 12.6% of visits (95% CI, 12.0%-13.3%) resulted in antibiotic prescriptions. Sinusitis was the single diagnosis associated with the most antibiotic prescriptions per 1000 population (56 antibiotic prescriptions [95% CI, 48-64]), followed by suppurative otitis media (47 antibiotic prescriptions [95% CI, 41-54]), and pharyngitis (43 antibiotic prescriptions [95% CI, 38-49]). Collectively, acute respiratory conditions per 1000 population led to 221 antibiotic prescriptions (95% CI, 198-245) annually, but only 111 antibiotic prescriptions were estimated to be appropriate for these conditions. Per 1000 population, among all conditions and ages combined in 2010-2011, an estimated 506 antibiotic prescriptions (95% CI, 458-554) were written annually, and, of these, 353 antibiotic prescriptions were estimated to be appropriate antibiotic prescriptions. In the United States in 2010-2011, there was an estimated annual antibiotic prescription rate per 1000 population of 506, but only an estimated 353 antibiotic prescriptions were likely appropriate, supporting the need for establishing a goal for outpatient antibiotic stewardship.

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Mendeley readers

The data shown below were compiled from readership statistics for 963 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 5 <1%
Brazil 1 <1%
Colombia 1 <1%
Canada 1 <1%
United Kingdom 1 <1%
Unknown 954 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 136 14%
Student > Bachelor 112 12%
Researcher 107 11%
Student > Ph. D. Student 98 10%
Other 86 9%
Other 227 24%
Unknown 197 20%
Readers by discipline Count As %
Medicine and Dentistry 299 31%
Pharmacology, Toxicology and Pharmaceutical Science 74 8%
Biochemistry, Genetics and Molecular Biology 56 6%
Agricultural and Biological Sciences 52 5%
Nursing and Health Professions 44 5%
Other 178 18%
Unknown 260 27%

Attention Score in Context

This research output has an Altmetric Attention Score of 2197. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 February 2022.
All research outputs
#2,999
of 21,778,818 outputs
Outputs from JAMA: Journal of the American Medical Association
#111
of 32,109 outputs
Outputs of similar age
#34
of 279,598 outputs
Outputs of similar age from JAMA: Journal of the American Medical Association
#4
of 387 outputs
Altmetric has tracked 21,778,818 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 32,109 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 71.7. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 279,598 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 387 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 99% of its contemporaries.