Journal of Clinical Microbiology and Antimicrobials

Journal of Clinical Microbiology and Antimicrobials
Open Access



Evaluation of Adherence to Guidelines for Treatment of Acute Pharyngitis and Sinusitis in US Outpatient Settings

Ateequr Rahman, Yelena Sahakian

The aim of this study was to look at the appropriateness of prescribing patterns for acute sinusitis and acute pharyngitis and compare with treatment guidelines issued by the Center for Disease Control and Prevention (CDC). 2015 National Ambulatory Medical Care Survey (NAMCS) data were used to determine antibiotic prescribing practices of providers treating the two conditions. Inclusion criteria were primary diagnosis of acute sinusitis and acute pharyngitis. Amoxicillin or penicillin, as recommended first-line treatment, were considered appropriate agents for the purposes of this study. Demographic variables, such as gender, age and race were examined along withprescribing variables, including insurance type, geographic area and physician type. In 46 (23.8%) cases,inappropriate agent was chosen. General doctors (14), pediatricians (12) and otolaryngologists (10) were prescribed most of inappropriate prescriptions. Inappropriate antibiotics were often prescribed for patients under 15 (11) and 45 to 64 (11) years of age (X2=0.318), white patients (27) (X2=0.411), those with private insurance (30), (X2=0.726) and from South (13) and West (16) regions (X2 =0.410). Chi-square test found no correlation amongst gender, age, race, insurance type, geographic area or physician type being predictors of appropriate or inappropriate prescribing patterns. Binary logistic regression did not show strong interactions amongst the variables in terms of prescribing pattern, and R2 was found to be significant. Adherence to CDC guidelines to treat acute pharyngitis and sinusitis
can decrease the risk of bacteria developing resistance and translate into better clinical outcomes. Future research should continue identifying antibiotic prescribing trends for subsequent years.