Table 2.
Sociodemographic characteristics, exposures, and clinical features associated with antibiotic prescriptions among patients with influenza-like illness (ILI), southern Sri Lanka, March 2013–October 2014
| Characteristic | Phase 1 | Phase 2 | ||||
|---|---|---|---|---|---|---|
| Antibiotic prescribed, N = 257 | No antibiotic prescribed, N = 59 | P value | Antibiotic prescribed, N = 167 | No antibiotic prescribed, N = 74 | P value | |
| Age (years) | 13.1 (6.4–37.1) | 24.4 (7.7–47.8) | 0.14 | 12.9 (5.7–35.8) | 8.3 (5.2–24.3) | 0.08 |
| Adults ≥ 18 years | 112 (43.6%) | 33 (55.9%) | 0.11 | 71 (42.5%) | 22 (29.7%) | 0.06 |
| Male | 147 (57.2%) | 28 (47.5%) | 0.19 | 84 (50.3%) | 36 (48.7%) | 0.89 |
| Distance to THK (km) | 5 (3–15) | 5.5 (3–15) | 0.91 | 10 (4–20) | 8 (4–15) | 0.53 |
| Sick contact in past month | 109 (42.6%) | 28 (47.5%) | 0.56 | 75 (46.3%) | 34 (46.0%) | 1.00 |
| Travel in past month | 47 (18.3%) | 7 (11.9%) | 0.34 | 22 (13.3%) | 11 (14.9%) | 0.84 |
| Prior medical visit for same illness | 63 (24.6%) | 15 (25.9%) | 0.87 | 63 (38.2%) | 16 (22.2%) | 0.02 |
| Prior antibiotic use for same illness—yes/unsure | 57 (22.2%) | 13 (22.0%) | 1.00 | 38 (22.8%) | 6 (8.1%) | 0.006 |
| Days missed | ||||||
| Work (adults) | 1 (0–2) | 0 (0–1) | 0.02 | 0 (0–2) | 0 (0–1) | 0.68 |
| School (children) | 1 (0–2) | 1 (0–1) | 0.54 | 1 (0–2) | 1 (0–2) | 0.63 |
| Fever days | 2 (1–3) | 2 (1–2) | 0.05 | 3 (2–4) | 2 (2–3) | 0.02 |
| Cough days | 2 (1–3) | 2 (1–3) | 0.28 | 3 (2–4) | 2 (2–3) | 0.008 |
| Rhinitis/congestion | 155 (60.3%) | 33 (55.9%) | 0.56 | 157 (94.0%) | 65 (87.8%) | 0.12 |
| Sore throat | 134 (52.1%) | 25 (42.4%) | 0.20 | 68 (40.7%) | 27 (36.5%) | 0.57 |
| Shortness of breath | 70 (27.2%) | 14 (23.7%) | 0.63 | 4 (2.4%) | 0 (0%) | 0.32 |
| Pleuritic chest pain | 44 (17.1%) | 10 (17.0%) | 1.00 | 3 (1.8%) | 2 (2.7%) | 0.64 |
| Anorexia | 199 (77.4%) | 45 (76.3%) | 0.86 | 81 (48.5%) | 28 (37.8%) | 0.16 |
| Vomiting | 56 (21.8%) | 9 (15.3%) | 0.29 | 24 (14.4%) | 11 (14.9%) | 1.00 |
| Abdominal pain | 19 (7.4%) | 3 (5.1%) | 0.78 | 9 (5.4%) | 7 (9.5%) | 0.27 |
| Headache | 204 (79.4%) | 47 (79.7%) | 1.00 | 119 (71.3%) | 42 (56.8%) | 0.04 |
| Fatigue | 211 (82.1%) | 48 (81.4%) | 0.85 | 95 (56.9%) | 35 (47.3%) | 0.21 |
| Arthralgias | 183 (71.2%) | 43 (72.9%) | 0.87 | 73 (43.7%) | 26 (35.1%) | 0.26 |
| Myalgias | 187 (72.8%) | 45 (76.3%) | 0.63 | 71 (42.5%) | 26 (35.1%) | 0.32 |
| Clinical diagnosis | ||||||
| Upper respiratory illness | 63 (24.5%) | 4 (6.8%) | 0.002 | 112 (67.1%) | 39 (52.7%) | 0.04 |
| Lower respiratory illness | 41 (16.0%) | 5 (8.5%) | 0.16 | 17 (10.2%) | 3 (4.1%) | 0.13 |
| Unspecified viral illness | 102 (39.7%) | 43 (72.9%) | < 0.001 | 11 (6.6%) | 12 (16.2%) | 0.03 |
| Influenza | 0 | 0 | – | 26 (15.6%) | 20 (27.0%) | 0.05 |
| Positive rapid influenza test | 123 (48.6%) | 24 (41.4%) | 0.38 | 43 (25.8%) | 26 (35.6%) | 0.13 |
| Additional diagnostic test ordered | 59 (23.0%) | 6 (10.2%) | 0.03 | 30 (18.0%) | 7 (9.5%) | 0.12 |
THK = Teaching Hospital Karapitiya.
Bold indicates P values significant at less than 0.05. Characteristics between patients who received antibiotic prescriptions and those who did not receive antibiotic prescriptions are compared using Fisher's exact test for categorical variables and the Kruskall–Wallis test for continuous variables. The two phases of the study are analyzed separately, since the result from the rapid influenza test was only available to clinicians in the second phase and may have influenced antibiotic prescribing patterns