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Reducing unnecessary antibiotic prescribing for acute bronchitis is a key antibiotic stewardship goal set forth by the Centers for Disease Control and Prevention. Understanding what factors influence prescribing for bronchitis cases can inform antimicrobial stewardship initiatives. The goal of this study was to identify factors associated with antibiotic prescribing at a high-volume student health center at a large US university. The Pennsylvania State University Health Services offers on-campus medical care to a population of over 40,000 students and receives over 50,000 visits every year.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a retrospective chart review of acute bronchitis visits for the 2015\u20132016 academic year and used a multivariate logistic regression analysis to identify variables associated with antibiotic prescribing.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Findings during lung exams increased the likelihood of an antibiotic prescription (rales OR 13.95, 95% CI 3.31\u201380.73; rhonchi OR 5.50, 95% CI 3.08\u201310.00; percussion abnormality OR 13.02, 95% CI 4.00\u201350.09). Individual clinicians had dramatically different rates of prescribing (OR range 0.03\u201312.3). Male patients were more likely than female patients to be prescribed antibiotics (OR 1.68, 95% CI 1.17\u20132.41). Patients who reported longer duration since the onset of symptoms were slightly more likely to receive prescriptions (OR 1.04 per day, 95% CI 1.03\u20131.06), as were patients who reported worsening symptoms (OR 1.78, 95% CI 1.03\u20133.10). Visits with diagnoses or symptoms associated with viral infections or allergies were less likely to result in prescriptions (upper respiratory tract infection (URI) diagnosis OR 0.33, 95% CI 0.18\u20130.58; sneezing OR 0.39, 95% CI 0.17\u20130.86; vomiting OR 0.31, 95% CI 0.10\u20130.83). An exam finding of anterior cervical lymphadenopathy was associated with antibiotic prescribing (tender OR 3.85, 95% CI 1.70\u20138.83; general OR 2.63, 95% CI 1.25\u20135.54).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Suspicious findings during lung examinations (rales, rhonchi, percussion abnormality) and individual healthcare providers were important factors influencing antibiotic prescribing rates for acute bronchitis visits. Patient gender, worsening symptoms, duration of illness, symptoms associated with viral infections or allergies, and anterior cervical lymphadenopathy also influenced prescribing rates.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12879-020-4825-2","type":"journal-article","created":{"date-parts":[[2020,2,26]],"date-time":"2020-02-26T19:02:52Z","timestamp":1582743772000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Factors associated with antibiotic prescribing for acute bronchitis at a university health center"],"prefix":"10.1186","volume":"20","author":[{"given":"Valerie J.","family":"Morley","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily P. 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Honest brokers were employed and trained to access electronic medical records for clinical visits, extract deidentified data (data excluding information that could be used to identify individual patients), and enter it in the secure database manager REDCap for use by the researchers. Informed consent was waived by the IRB given the retrospective nature of the study and the use of honest brokers for deidentification.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"177"}}