National Disparities in Antibiotic Prescribing by Race, Ethnicity, Age Group, and Sex in United States Ambulatory Care Visits, 2009 to 2016

Eric H Young; Kelsey A Strey; Grace C Lee; Travis J Carlson; Jim M Koeller; Vidal M Mendoza; Kelly R Reveles

doi:10.3390/antibiotics12010051

National Disparities in Antibiotic Prescribing by Race, Ethnicity, Age Group, and Sex in United States Ambulatory Care Visits, 2009 to 2016

Antibiotics (Basel). 2022 Dec 28;12(1):51. doi: 10.3390/antibiotics12010051.

Authors

Eric H Young^{1

2}, Kelsey A Strey^{1

2}, Grace C Lee^{1

2}, Travis J Carlson³, Jim M Koeller^{1

2}, Vidal M Mendoza^{1

2}, Kelly R Reveles^{1

2}

Affiliations

¹ College of Pharmacy, The University of Texas at Austin, Austin, TX 78701, USA.
² Pharmacotherapy Education & Research Center, University of Texas Health San Antonio, San Antonio, TX 78229, USA.
³ Fred Wilson School of Pharmacy, High Point University, High Point, NC 27268, USA.

Abstract

While efforts have been made in the United States (US) to optimize antimicrobial use, few studies have explored antibiotic prescribing disparities that may drive future interventions. The objective of this study was to evaluate disparities in antibiotic prescribing among US ambulatory care visits by patient subgroups. This was a retrospective, cross-sectional study utilizing the National Ambulatory Medical Care Survey from 2009 to 2016. Antibiotic use was described as antibiotic visits per 1000 total patient visits. The appropriateness of antibiotic prescribing was determined by ICD-9 or ICD-10 codes assigned during the visit. Subgroup analyses were conducted by patient race, ethnicity, age group, and sex. Over 7.0 billion patient visits were included; 11.3% included an antibiotic prescription. Overall and inappropriate antibiotic prescription rates were highest in Black (122.2 and 78.0 per 1000) and Hispanic patients (138.6 and 79.8 per 1000). Additionally, overall antibiotic prescription rates were highest in patients less than 18 years (169.6 per 1000) and female patients (114.1 per 1000), while inappropriate antibiotic prescription rates were highest in patients 18 to 64 years (66.0 per 1000) and in males (64.8 per 1000). In this nationally representative study, antibiotic prescribing disparities were found by patient race, ethnicity, age group, and sex.

Keywords: antibiotics; epidemiology; health disparities.

Grants and funding

This research received no external funding.