TABLE 1.
Antibiotic selection for pharyngitis, sinusitis, and pediatric AOM visits, according to setting, in 2014
| Condition and druga | No. (%) |
||||
|---|---|---|---|---|---|
| Retail clinic (n = 13,889) | ED (n = 107,820) | Urgent care (n = 474,378) | Medical office (n = 4,268,329) | Total (n = 4,864,416) | |
| Pharyngitis (pediatric and adult) | |||||
| First-line total | 3,420 (72.2) | 24,709 (51.0) | 83,994 (46.1) | 604,395 (46.3) | 716,518 (46.5) |
| Amoxicillin | 2,410 (50.9) | 20,173 (41.6) | 74,725 (41.0) | 543,659 (41.6) | 640,967 (41.6) |
| Penicillin | 1,010 (21.3) | 4,536 (9.4) | 9,269 (5.1) | 60,736 (4.6) | 75,551 (4.9) |
| Non-first-line total | 1,314 (27.8) | 23,760 (49.0) | 98,203 (53.9) | 702,066 (53.7) | 825,343 (53.5) |
| Amoxicillin-clavulanate | 273 (5.8) | 4,614 (9.5) | 19,571 (10.7) | 133,361 (10.2) | 157,819 (10.2) |
| Macrolide | 739 (15.6) | 13,095 (27.0) | 50,553 (27.7) | 329,236 (25.2) | 393,623 (25.5) |
| Cephalosporin | 225 (4.8) | 3,362 (6.9) | 22,822 (12.5) | 195,562 (15.0) | 221,971 (14.4) |
| Quinolone | 12 (0.3) | 464 (1.0) | 1,804 (1.0) | 19,493 (1.5) | 21,773 (1.4) |
| Other | 65 (1.4) | 2,225 (4.6) | 3,453 (1.9) | 24,414 (1.9) | 30,157 (2.0) |
| Pharyngitis total | 4,734 | 48,469 | 182,197 | 1,306,461 | 1,541,861 |
| Sinusitis (pediatric and adult) | |||||
| First-line total | 5,448 (68.3) | 16,543 (48.9) | 114,047 (46.8) | 1,018,773 (45.4) | 1,154,811 (45.6) |
| Amoxicillin | 991 (12.4) | 6,205 (18.4) | 40,601 (16.7) | 401,935 (17.9) | 449,732 (17.8) |
| Amoxicillin-clavulanate | 4,457 (55.9) | 10,338 (30.6) | 73,446 (30.2) | 616,838 (27.5) | 705,079 (27.9) |
| Non-first-line total | 2,530 (31.7) | 17,262 (51.1) | 129,480 (53.2) | 1,226,137 (54.6) | 1,375,409 (54.4) |
| Macrolide | 1,023 (12.8) | 10,541 (31.2) | 71,563 (29.4) | 613,835 (27.3) | 696,962 (27.5) |
| Cephalosporin | 405 (5.1) | 2,152 (6.4) | 32,175 (13.2) | 321,306 (14.3) | 356,038 (14.1) |
| Quinolone | 206 (2.6) | 2,119 (6.3) | 12,359 (5.1) | 163,586 (7.3) | 178,270 (7.0) |
| Other | 896 (11.2) | 2,450 (7.2) | 13,383 (5.5) | 127,410 (5.7) | 144,139 (5.7) |
| Sinusitis total | 7,978 | 33,805 | 243,527 | 2,244,910 | 2,530,220 |
| AOM (pediatric only) | |||||
| First-line total | 922 (78.3) | 20,003 (78.3) | 33,806 (69.5) | 504,098 (70.3) | 558,829 (70.5) |
| Amoxicillin | 771 (65.5) | 17,404 (68.1) | 28,302 (58.2) | 408,561 (57.0) | 455,038 (57.4) |
| Amoxicillin-clavulanate | 151 (12.8) | 2,599 (10.2) | 5,504 (11.3) | 95,537 (13.3) | 103,791 (13.1) |
| Non-first-line total | 255 (21.7) | 5,543 (21.7) | 14,848 (30.5) | 212,860 (29.7) | 233,506 (29.5) |
| Macrolide | 139 (11.8) | 3,012 (11.8) | 6,257 (12.9) | 67,747 (9.4) | 77,155 (9.7) |
| Cephalosporin | 108 (9.2) | 2,278 (8.9) | 8,239 (16.9) | 139,014 (19.4) | 149,639 (18.9) |
| Quinolone | 0 (0.0) | 14 (0.1) | 22 (0.0) | 248 (0.0) | 284 (0.0) |
| Other | 8 (0.7) | 239 (0.9) | 330 (0.7) | 5,851 (0.8) | 6,428 (0.8) |
| AOM total | 1,177 | 25,546 | 48,654 | 716,958 | 792,335 |
First-line therapy included amoxicillin or penicillin for pharyngitis and amoxicillin or amoxicillin-clavulanate for sinusitis and AOM. Non-first-line therapy included all antibiotics not considered first-line therapy for the diagnosis of interest. To focus on uncomplicated visits, visits with multiple antibiotics were excluded if the antibiotics were from more than one of the antibiotic subcategories listed (subcategories for sinusitis and AOM included amoxicillin, amoxicillin-clavulanate, macrolide, cephalosporin, quinolone, and other; pharyngitis had an additional penicillin subcategory). For example, a visit for which both a macrolide and a cephalosporin were prescribed (two different categories of non-first-line agents) would be excluded.