Table 3.
Association between rural residence and suboptimal antibiotic use by infection diagnosis.
| Suboptimal Antibiotic Use by Infection Diagnosis | Rural-Residing Veterans, n (%) | Urban-Residing Veterans, n (%) | Adjusted Odds Ratio | Lower 95% Confidence Interval | Upper 95% Confidence Interval |
|---|---|---|---|---|---|
| Fluoroquinolone exposure a | |||||
| Upper respiratory infection | 21,876 (12.1%) | 60,639 (10.1%) | 1.10 | 1.08 | 1.11 |
| Pneumonia | 12,929 (50%) | 39,126 (49.2%) | 0.94 | 0.93 | 1.02 |
| Urinary tract infection | 23,950 (48.6%) | 84,841 (48.9%) | 0.92 | 0.90 | 0.94 |
| Skin and soft tissue infection | 5633 (7.6%) | 16,801 (6.4%) | 1.12 | 1.09 | 1.16 |
| Longer antibiotic course *,b | |||||
| Upper respiratory infection | 91,276 (50.6%) | 269,462 (44.8%) | 1.21 | 1.20 | 1.22 |
| Pneumonia | 9211 (35.6%) | 25,730 (32.4%) | 1.11 | 1.08 | 1.14 |
| Urinary tract infection | 25,796 (52.4%) | 78,181 (45%) | 1.23 | 1.20 | 1.25 |
| Skin and soft tissue infection | 50,966 (68.7%) | 168,205 (64%) | 1.16 | 1.14 | 1.18 |
Bold indicates the p-value < 0.05 for the comparison of rural and nonrural residence. The adjusted odds ratios were estimated from generalized linear mixed models with a binary distribution and logit link, accounting for clustering by region and year. * Longer antibiotic courses were defined as prescriptions with durations of ten days or greater. a Adjusted for age, cerebrovascular disease, chronic pulmonary disease, hypertension, liver disease, peripheral vascular disease, malignancy, Charlson comorbidity score higher than the median, sex, race, region, and year. b Adjusted for age, atherosclerosis, alcohol disorder, cerebrovascular disease, Elixhauser score higher than the median, depression, hypertension, liver disease, myocardial infarction, obesity, malignancy, Hispanic ethnicity, marital status, sex, race, region, and year.