National trends in visit rates and antibiotic prescribing for children with acute sinusitis

Daniel J. Shapiro, Ralph Gonzales, Michael D. Cabana, Adam L. Hersh

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

OBJECTIVE: The heptavalent pneumococcal conjugate vaccine contributed to a substantial decrease in the number of ambulatory visits attributable to acute otitis media (AOM) and amoxicillin use for AOM increased after publication of American Academy of Pediatrics guidelines regarding AOM. Our objective was to determine whether similar trends occurred for children with acute sinusitis. METHODS: We analyzed data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey (1998-2007), which are nationally representative surveys of office and emergency department visits. For children younger than 18 years with diagnosed acute sinusitis (N = 538), we examined time trends in visit rates and antibiotic prescribing. Multivariate logistic regression analyses were used to identify factors associated with narrow-spectrum antibiotic prescribing. RESULTS: Between 1998 and 2007, the annual visit rate for acute sinusitis remained stable, ranging from 11 to 14 visits per 1000 children (P = .67). No change occurred in the proportion of visits with receipt of an antibiotic (82%; P = .71); however, the proportion with receipt of amoxicillin increased from 19% to 58% during the study period (P < .01). Prescriptions for broader-spectrum agents, especially macrolides (18% overall), remained common. CONCLUSIONS: Unlike the visit rate for AOM, the visit rate for acute sinusitis among children did not decrease after introduction of the pneumococcal conjugate vaccine. Although prescriptions for amoxicillin increased in accordance with the guidelines, reducing unnecessary prescriptions for macrolides remains an important target for campaigns promoting judicious antibiotic use.

Original languageEnglish (US)
Pages (from-to)28-34
Number of pages7
JournalPediatrics
Volume127
Issue number1
DOIs
StatePublished - Jan 1 2011
Externally publishedYes

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Sinusitis
Otitis Media
Amoxicillin
Anti-Bacterial Agents
Health Care Surveys
Prescriptions
Macrolides
Guidelines
Conjugate Vaccines
Pneumococcal Vaccines
Publications
Hospital Emergency Service
Logistic Models
Regression Analysis
Pediatrics

Keywords

  • Antibiotic use
  • Physician practice patterns
  • Sinusitis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

National trends in visit rates and antibiotic prescribing for children with acute sinusitis. / Shapiro, Daniel J.; Gonzales, Ralph; Cabana, Michael D.; Hersh, Adam L.

In: Pediatrics, Vol. 127, No. 1, 01.01.2011, p. 28-34.

Research output: Contribution to journalArticle

Shapiro, Daniel J. ; Gonzales, Ralph ; Cabana, Michael D. ; Hersh, Adam L. / National trends in visit rates and antibiotic prescribing for children with acute sinusitis. In: Pediatrics. 2011 ; Vol. 127, No. 1. pp. 28-34.
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