{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T05:38:11Z","timestamp":1779341891893,"version":"3.51.4"},"reference-count":29,"publisher":"Cambridge University Press (CUP)","issue":"12","license":[{"start":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T00:00:00Z","timestamp":1661472000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X21005225_as1\"><jats:title>Objective:<\/jats:title><jats:p>To describe national antibiotic prescribing for acute gastroenteritis (AGE).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21005225_as2\"><jats:title>Setting:<\/jats:title><jats:p>Ambulatory care.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21005225_as3\"><jats:title>Methods:<\/jats:title><jats:p>We included visits with diagnoses for bacterial and viral gastrointestinal infections from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey (NAMCS\/NHAMCS; 2006\u20132015) and the IBM Watson 2014 MarketScan Commercial Claims and Encounters Database. For NAMCS\/NHAMCS, we calculated annual percentage estimates and 99% confidence intervals (CIs) of visits with antibiotics prescribed; sample sizes were too small to calculate estimates by pathogen. For MarketScan, we used Poisson regression to calculate the percentage of visits with antibiotics prescribed and 95% CIs, including by pathogen.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21005225_as4\"><jats:title>Results:<\/jats:title><jats:p>We included 10,210 NAMCS\/NHAMCS AGE visits; an estimated 13.3% (99% CI, 11.2%\u201315.4%) resulted in antibiotic prescriptions, most frequently fluoroquinolones (28.7%; 99% CI, 21.1%\u201336.3%), nitroimidazoles (20.2%; 99% CI, 14.0%\u201326.4%), and penicillins (18.9%; 99% CI, 11.6%\u201326.2%). In NAMCS\/NHAMCS, antibiotic prescribing was least frequent in emergency departments (10.8%; 99% CI, 9.5%\u201312.1%). Among 1,868,465 MarketScan AGE visits, antibiotics were prescribed for 13.8% (95% CI, 13.7%\u221213.8%), most commonly for <jats:italic>Yersinia<\/jats:italic> (46.7%; 95% CI, 21.4%\u201371.9%), <jats:italic>Campylobacter<\/jats:italic> (44.8%; 95% CI, 41.5%\u201348.1%), <jats:italic>Shigella<\/jats:italic> (39.7%; 95% CI, 35.9%\u201343.6%), typhoid or paratyphoid fever (32.7%; (95% CI, 27.2%\u201338.3%), and nontyphoidal <jats:italic>Salmonella<\/jats:italic> (31.7%; 95% CI, 29.5%\u201333.9%). Antibiotics were prescribed for 12.3% (95% CI, 11.7%\u201313.0%) of visits for viral gastroenteritis.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21005225_as5\"><jats:title>Conclusions:<\/jats:title><jats:p>Overall, \u223c13% of AGE visits resulted in antibiotic prescriptions. Antibiotics were unnecessarily prescribed for viral gastroenteritis and some bacterial infections for which antibiotics are not recommended. Antibiotic stewardship assessments and interventions for AGE are needed in ambulatory settings.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2021.522","type":"journal-article","created":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T09:03:28Z","timestamp":1661504608000},"page":"1880-1889","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":15,"title":["Antibiotic prescribing for acute gastroenteritis during ambulatory care visits\u2014United States, 2006\u20132015"],"prefix":"10.1017","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1549-2485","authenticated-orcid":false,"given":"Jennifer P.","family":"Collins","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7785-4712","authenticated-orcid":false,"given":"Laura M.","family":"King","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2358-8743","authenticated-orcid":false,"given":"Sarah A.","family":"Collier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Person","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan E.","family":"Gerdes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5709-2773","authenticated-orcid":false,"given":"Stacy M.","family":"Crim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monina","family":"Bartoces","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine E.","family":"Fleming-Dutra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cindy R.","family":"Friedman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1165-1162","authenticated-orcid":false,"given":"Louise K.","family":"Francois Watkins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2022,8,26]]},"reference":[{"key":"S0899823X21005225_ref12","unstructured":"12. National Center for Health Statistics. Ambulatory healthcare data: reliability of estimates. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/nchs\/ahcd\/ahcd_estimation_reliability.htm Published 2015. Accessed August 18, 2021."},{"key":"S0899823X21005225_ref26","doi-asserted-by":"crossref","first-page":"ofaa244","DOI":"10.1093\/ofid\/ofaa244","article-title":"Primary care physicians\u2019 attitudes and perceptions towards antibiotic resistance and antibiotic stewardship: a national survey","volume":"7","author":"Zetts","year":"2020","journal-title":"Open forum Infect Dis"},{"key":"S0899823X21005225_ref9","unstructured":"9. National Center for Health Statistics. 2012 NAMCS Micro-Data File Documentation. Centers for Disease Control and Prevention website. https:\/\/ftp.cdc.gov\/pub\/Health_Statistics\/NCHS\/Dataset_Documentation\/NAMCS\/doc2012.pdf. Published 2021. 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Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}