{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:59:57Z","timestamp":1792083597113,"version":"4.4.0"},"reference-count":30,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To determine whether racial differences exist in antibiotic prescribing among children treated by the same clinician.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Retrospective cohort study of 1\u2009296\u2009517 encounters by 208\u2009015 children to 222 clinicians in 25 practices in 2009. Clinical, antibiotic prescribing, and demographic data were obtained from a shared electronic health record. We estimated within-clinician associations between patient race (black versus nonblack) and (1) antibiotic prescribing or (2) acute respiratory tract infection diagnosis after adjusting for potential patient-level confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Black children were less likely to receive an antibiotic prescription from the same clinician per acute visit (23.5% vs 29.0%, odds ratio [OR] 0.75; 95% confidence interval [CI]: 0.72\u20130.77) or per population (0.43 vs 0.67 prescriptions\/child\/year, incidence rate ratio 0.64; 95% CI 0.63\u20130.66), despite adjustment for age, gender, comorbid conditions, insurance, and stratification by practice. Black children were also less likely to receive diagnoses that justified antibiotic treatment, including acute otitis media (8.7% vs 10.7%, OR 0.79; 95% CI 0.75\u20130.82), acute sinusitis (3.6% vs 4.4%, OR 0.79; 95% CI 0.73\u20130.86), and group A streptococcal pharyngitis (2.3% vs 3.7%, OR 0.60; 95% CI 0.55\u20130.66). When an antibiotic was prescribed, black children were less likely to receive broad-spectrum antibiotics at any visit (34.0% vs 36.9%, OR 0.88; 95% CI 0.82\u20130.93) and for acute otitis media (31.7% vs 37.8%, OR 0.75; 95% CI 0.68\u20130.83).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>When treated by the same clinician, black children received fewer antibiotic prescriptions, fewer acute respiratory tract infection diagnoses, and a lower proportion of broad-spectrum antibiotic prescriptions than nonblack children. Reasons for these differences warrant further study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2012-2500","type":"journal-article","created":{"date-parts":[[2013,3,18]],"date-time":"2013-03-18T21:50:45Z","timestamp":1363643445000},"page":"677-684","source":"Crossref","is-referenced-by-count":157,"title":["Racial Differences in Antibiotic Prescribing by Primary Care Pediatricians"],"prefix":"10.1542","volume":"131","author":[{"given":"Jeffrey S.","family":"Gerber","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases,"},{"name":"The Center for Pediatric Clinical Effectiveness,"},{"name":"Department of Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya A.","family":"Prasad","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases,"},{"name":"The Center for Pediatric Clinical Effectiveness,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Russell","family":"Localio","sequence":"additional","affiliation":[{"name":"The Center for Pediatric Clinical Effectiveness,"},{"name":"PolicyLab,"},{"name":"Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander G.","family":"Fiks","sequence":"additional","affiliation":[{"name":"The Center for Pediatric Clinical Effectiveness,"},{"name":"Department of Pediatrics, and"},{"name":"PolicyLab,"},{"name":"Division of General Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert W.","family":"Grundmeier","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, and"},{"name":"Division of General Pediatrics, and"},{"name":"The Center for Biomedical Informatics, The Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis M.","family":"Bell","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases,"},{"name":"The Center for Pediatric Clinical Effectiveness,"},{"name":"Department of Pediatrics, and"},{"name":"Division of General Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard C.","family":"Wasserman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Vermont College of Medicine, Burlington, Vermont"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Rubin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, and"},{"name":"PolicyLab,"},{"name":"Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; and"},{"name":"Division of General Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Keren","sequence":"additional","affiliation":[{"name":"The Center for Pediatric Clinical Effectiveness,"},{"name":"Department of Pediatrics, and"},{"name":"Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; and"},{"name":"Division of General Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theoklis E.","family":"Zaoutis","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases,"},{"name":"The Center for Pediatric Clinical Effectiveness,"},{"name":"Department of Pediatrics, and"},{"name":"Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; 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