Table 3:

Factors associated with first-line, guideline-concordant antibiotic prescribing for acute otitis media, sinusitis, and pharyngitis in ED visits by children, United States, 2009–2014.

Characteristic*	Percentage of visits in which first-line, guideline-concordant antibiotics were prescribed, among all visits in which antibiotics were prescribed (95% CI)	p(χ2)	Adjusted Odds Ratio (95% CI) for first-line, guideline-concordant prescribing
Age (years)		0.12
<1	80% (74–85%)		1.00
1–4	80% (76–83%)		1.07 (0.68–1.70)
5–12	78% (74–81%)		1.11 (0.68–1.82)
13–17	72% (66–77%)		0.92 (0.49–1.72)
Sex		0.89
Male	78% (75–81%)		1.00
Female	78% (75–81%)		1.01 (0.78–1.30)
Race		<0.01
White	76% (73–79%)		1.00
Black	81% (75–85%)		1.56 (1.15–2.11)
Insurance status		0.08
Private	75% (70–79%)		1.00
Non-private	79% (76–82%)		1.32 (0.99–1.76)
US Census Region+		0.04
Northeast	86% (83–89%)		1.00
Midwest	78% (74–83%)		0.51 (0.34–0.77)
South	76% (72–80%)		0.46 (0.32–0.67)
West	77% (72–82%)		0.55 (0.35–0.87)
Advanced Practice Practitioner present at ED Visit		0.58
No	78% (75–80%)		1.00
Yes	79% (75–83%)		1.08 (0.84–1.39)
Type of ED		<0.001
Non-Pediatric	77% (75–79%)		1.00
Pediatric	87% (82–90%)		2.01 (1.38–2.92)
Diagnosis		<0.01
Acute Otitis Media	81% (78–84%)		1.00
Sinusitis	70% (60–78%)		0.51 (0.32–0.82)
Pharyngitis	74% (71–78%)		0.72 (0.53–0.96)
Modeled using 2009–11 and 2013–14
Metropolitan Statistical Area (MSA)		<0.001
Non-MSA	71% (68–75%)		1.00
MSA	79% (75–80%)		1.26 (0.99–1.60)

^*Data on MSA were not publicly available in 2012. The main model to determine the odds ratio estimates for each variable included all listed variables other than MSA. Odds ratio estimates for MSA are from a separate model that adjusted for all other variables, but excluded observations from 2012.

⁺U.S. Census Regions defined by the U.S. Census Bureau²⁰