{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:42:32Z","timestamp":1790145752117,"version":"4.0.1"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Antibiotics are commonly prescribed for children with acute respiratory infections (ARIs). This study describes the distribution of ARI diagnoses and specifically quantifies antibiotic dispensing for bronchitis and upper respiratory infection (URI) by treatment setting and specialty.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>This retrospective, observational cross-sectional study used data from the HealthCore Integrated Research Environment containing claims from 14 commercial health plans for 2012 to 2014. Children (2\u201317 years) with first-episode ARI were identified by diagnosis of acute otitis media (AOM), sinusitis, pharyngitis, bronchitis or URI with no competing infections or chronic illnesses. Treatment setting was where diagnoses were made: primary care offices, urgent care centers (UCC), retail health clinics (RHCs) or emergency departments. Primary outcome measure was antibiotic prescription fills from pharmacies within 2 days of start of ARI episode.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>For URI, the highest proportions in antibiotic dispensing were ordered by office-based or UCC family physicians (28% and 30%, respectively) and office-based or UCC nurse practitioners\/physician assistants (30% and 29%, respectively). Across all settings and specialties, there was high proportion of antibiotic dispensing for bronchitis (75%). Overall, 48% of 544,531 children diagnosed with ARI filled antibiotics. Nurse practitioners\/physician assistants in RHC made the most diagnoses of AOM (24%) and streptococcal pharyngitis (22%).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Outreach efforts to decrease antibiotic dispensing for URI can be focused on office-based and UCC family physicians and nurse practitioners\/physician assistants. All specialties need widespread interventions to reduce antibiotic dispensing for bronchitis. RHC nurse practitioners\/physician assistants can be targeted to reduce high proportion of AOM and streptococcal pharyngitis diagnoses.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/inf.0000000000002004","type":"journal-article","created":{"date-parts":[[2018,3,27]],"date-time":"2018-03-27T20:40:01Z","timestamp":1522183201000},"page":"1248-1254","source":"Crossref","is-referenced-by-count":28,"title":["Variation in Outpatient Antibiotic Dispensing for Respiratory Infections in Children by Clinician Specialty and Treatment Setting"],"prefix":"10.1097","volume":"37","author":[{"given":"Abiy","family":"Agiro","sequence":"first","affiliation":[{"name":"Translational Research for Affordability and Quality, HealthCore, Inc, Wilmington, Delaware"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santosh","family":"Gautam","sequence":"additional","affiliation":[{"name":"Translational Research for Affordability and Quality, HealthCore, Inc, Wilmington, Delaware"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Wall","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse","family":"Hackell","sequence":"additional","affiliation":[{"name":"Pomona Pediatrics, Children\u2019s and Women\u2019s Physicians of Westchester, Pomona, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Helm","sequence":"additional","affiliation":[{"name":"General Pediatrics, Childhood Health Associates of Salem, Salem, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Barron","sequence":"additional","affiliation":[{"name":"HealthCore, Inc, Wilmington, Delaware"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theoklis","family":"Zaoutis","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, The Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine E.","family":"Fleming-Dutra","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauri A.","family":"Hicks","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Medical and Clinical Pharmacy Policy, Anthem, Inc, Chicago, Illinois."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20230912","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1542\/peds.2011-2879","article-title":"Trends of outpatient prescription drug utilization in US children, 2002-2010.","volume":"130","author":"Chai","year":"2012","journal-title":"Pediatrics"},{"key":"R2-20230912","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1001\/jama.2016.4151","article-title":"Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011.","volume":"315","author":"Fleming-Dutra","year":"2016","journal-title":"JAMA"},{"key":"R3-20230912","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1001\/archpedi.156.11.1114","article-title":"Antibiotic prescribing by primary care physicians for children with upper respiratory tract infections.","volume":"156","author":"Nash","year":"2002","journal-title":"Arch Pediatr Adolesc Med"},{"key":"R4-20230912","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1542\/peds.2013-2903","article-title":"Recent trends in outpatient antibiotic use in children.","volume":"133","author":"Vaz","year":"2014","journal-title":"Pediatrics"},{"key":"R10-20230912","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1001\/archinte.163.4.487","article-title":"The economic burden of non-influenza-related viral respiratory tract infection in the United States.","volume":"163","author":"Fendrick","year":"2003","journal-title":"Arch Intern Med"},{"key":"R11-20230912","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr6506a1","article-title":"Core elements of outpatient antibiotic stewardship.","volume":"65","author":"Sanchez","year":"2016","journal-title":"MMWR Recomm Rep"},{"key":"R12-20230912","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1001\/archinternmed.2012.950","article-title":"Large-scale validation of the Centor and McIsaac scores to predict group A streptococcal pharyngitis.","volume":"172","author":"Fine","year":"2012","journal-title":"Arch Intern Med"},{"key":"R13-20230912","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1542\/peds.2011-1337","article-title":"Antibiotic prescribing in ambulatory pediatrics in the United States.","volume":"128","author":"Hersh","year":"2011","journal-title":"Pediatrics"},{"key":"R14-20230912","doi-asserted-by":"crossref","first-page":"e956","DOI":"10.1542\/peds.2014-0605","article-title":"Bacterial prevalence and antimicrobial prescribing trends for acute respiratory tract infections.","volume":"134","author":"Kronman","year":"2014","journal-title":"Pediatrics"},{"key":"R16-20230912","first-page":"294","article-title":"Antibiotic prescribing for respiratory infections at retail clinics, physician practices, and emergency departments.","volume":"21","author":"Mehrotra","year":"2015","journal-title":"Am J Manag Care"},{"key":"R18-20230912","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1056\/NEJMc1212055","article-title":"U.S. outpatient antibiotic prescribing, 2010.","volume":"368","author":"Hicks","year":"2013","journal-title":"N Engl J Med"},{"key":"R20-20230912","doi-asserted-by":"crossref","first-page":"e72","DOI":"10.1093\/cid\/cis370","article-title":"IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults.","volume":"54","author":"Chow","year":"2012","journal-title":"Clin Infect Dis"},{"key":"R21-20230912","doi-asserted-by":"crossref","first-page":"e964","DOI":"10.1542\/peds.2012-3488","article-title":"The diagnosis and management of acute otitis media.","volume":"131","author":"Lieberthal","year":"2013","journal-title":"Pediatrics"},{"issue":"suppl 1","key":"R22-20230912","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1542\/peds.101.S1.178","article-title":"Cough illness\/bronchitis \u2013 principles of judicious use of antimicrobial agents.","volume":"101","author":"O\u2019Brien","year":"1998","journal-title":"Pediatrics"},{"issue":"suppl 1","key":"R23-20230912","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1542\/peds.101.S1.181","article-title":"The common cold \u2013 principles of judicious use of antimicrobial agents.","volume":"101","author":"Rosenstein","year":"1998","journal-title":"Pediatrics"},{"key":"R24-20230912","doi-asserted-by":"crossref","first-page":"e86","DOI":"10.1093\/cid\/cis629","article-title":"Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America.","volume":"55","author":"Shulman","year":"2012","journal-title":"Clin Infect Dis"},{"key":"R25-20230912","doi-asserted-by":"crossref","first-page":"e262","DOI":"10.1542\/peds.2013-1071","article-title":"Clinical practice guideline for the diagnosis and management of acute bacterial sinusitis in children aged 1 to 18 years.","volume":"132","author":"Wald","year":"2013","journal-title":"Pediatrics"},{"key":"R26-20230912","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1093\/jac\/dkt301","article-title":"Antibiotic prescribing for adults in ambulatory care in the USA, 2007-09.","volume":"69","author":"Shapiro","year":"2014","journal-title":"J Antimicrob Chemother"},{"key":"R27-20230912","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1093\/jpids\/piu086","article-title":"Variation in antibiotic prescribing across a pediatric primary care network.","volume":"4","author":"Gerber","year":"2015","journal-title":"J Pediatric Infect Dis Soc"},{"key":"R28-20230912","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1542\/peds.2014-1781","article-title":"Race, otitis media, and antibiotic selection.","volume":"134","author":"Fleming-Dutra","year":"2014","journal-title":"Pediatrics"},{"key":"R29-20230912","doi-asserted-by":"crossref","first-page":"e385","DOI":"10.1542\/peds.113.5.e385","article-title":"Racial\/ethnic variation in parent expectations for antibiotics: implications for public health campaigns.","volume":"113","author":"Mangione-Smith","year":"2004","journal-title":"Pediatrics"},{"issue":"4 pt 1","key":"R30-20230912","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1542\/peds.103.4.711","article-title":"The relationship between perceived parental expectations and pediatrician antimicrobial prescribing behavior.","volume":"103","author":"Mangione-Smith","year":"1999","journal-title":"Pediatrics"},{"key":"R31-20230912","first-page":"e217","article-title":"Unintended consequences of a quality measure for acute bronchitis.","volume":"18","author":"Roth","year":"2012","journal-title":"Am J Manag Care"},{"key":"R32-20230912","first-page":"23","article-title":"The effect of parental expectations on treatment of children with a cough: a report from ASPN.","volume":"37","author":"Vinson","year":"1993","journal-title":"J Fam Pract"},{"key":"R33-20230912","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1001\/jamainternmed.2013.1984","article-title":"Antibiotic Prescribing for acute respiratory infections\u2013success that\u2019s way off the mark: comment on \u201cA cluster randomized trial of decision support strategies for reducing antibiotic use in acute bronchitis\u201d.","volume":"173","author":"Linder","year":"2013","journal-title":"JAMA Intern Med"},{"key":"R34-20230912","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1001\/jamainternmed.2013.14191","article-title":"Nudging guideline-concordant antibiotic prescribing: a randomized clinical trial.","volume":"174","author":"Meeker","year":"2014","journal-title":"JAMA Intern Med"},{"key":"R35-20230912","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1007\/s11606-014-3051-2","article-title":"Nudging physician prescription decisions by partitioning the order set: results of a vignette-based study.","volume":"30","author":"Tannenbaum","year":"2015","journal-title":"J Gen Intern Med"},{"key":"R36-20230912","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1001\/jama.2016.0275","article-title":"Effect of behavioral interventions on inappropriate antibiotic prescribing among primary care practices: a randomized clinical trial.","volume":"315","author":"Meeker","year":"2016","journal-title":"JAMA"},{"key":"R37-20230912","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.ajem.2004.10.015","article-title":"Pediatrician prescription pick-up rates after ED visits.","volume":"23","author":"Kajioka","year":"2005","journal-title":"Am J Emerg Med"}],"container-title":["Pediatric Infectious Disease Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00006454-201812000-00010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T23:08:43Z","timestamp":1694560123000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00006454-201812000-00010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12]]},"references-count":29,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1097\/inf.0000000000002004","relation":{},"ISSN":["0891-3668"],"issn-type":[{"value":"0891-3668","type":"print"}],"subject":[],"published":{"date-parts":[[2018,12]]}}}