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Geographic Variability in Diagnosis and Antibiotic Prescribing for Acute Respiratory Tract Infections

机译：急性呼吸道感染的诊断和抗生素处方的地理变异性

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IntroductionAntibiotic prescribing rates vary substantially across regions in the USA. Whether these differences are driven primarily by a greater tendency to treat certain infections (i.e., overtreatment) in certain regions or differences in the tendency to diagnose certain infections (i.e., overdiagnosis) is poorly understood. MethodsWe examined data from 2012 to 2013 using the National Ambulatory Medical Care Survey, which is a nationally representative sample of visits to office-based physicians. For each of nine geographic regions, we examined the relationship between the visit rate/1000 population for respiratory diagnoses for which antibiotics were prescribed to the visit rate/1000 population for selected respiratory diagnoses where antibiotic therapy may be warranted. ResultsThe visit rate for all respiratory conditions resulting in an antibiotic prescription was lowest (109/1000 population) in the Pacific Region and highest (176/1000, 95% CI 138–213) in the East South Central Region. The diagnosis rate for selected respiratory conditions where antibiotic therapy may be warranted was also lowest (119/1000, 95% CI 91–147) in the Pacific Region and highest (189/1000, 95% CI 153–225) in the East South Central Region. ConclusionAntibiotic prescribing rates for respiratory conditions vary by region and are strongly associated with the rate with which selected respiratory conditions are diagnosed.
机译：引言在美国不同地区，抗生素处方率存在很大差异。这些差异是主要由某些地区中某些感染的较大治疗趋势（即过度治疗）还是诊断某些感染的趋势差异（即过度诊断）驱动的，人们对此知之甚少。方法我们使用全国门诊医疗调查（National Ambulatory Medical Care Survey）检查了2012年至2013年的数据，这是全国代表性的就诊医生的样本。对于九个地理区域中的每一个，我们检查了处方了抗生素的呼吸系统诊断的就诊率/ 1000人口与可能需要进行抗生素治疗的特定呼吸系统诊断的就诊率/ 1000人口之间的关系。结果导致抗生素处方的所有呼吸系统疾病的就诊率在太平洋地区最低（109/1000人口），在东南中部地区最高（176 / 1000，95％CI 138–213）。在太平洋地区，某些可能需要进行抗生素治疗的呼吸道疾病的诊断率也最低（119 / 1000，95％CI 91-147），在东南部最高（189 / 1000，95％CI 153-225）中央区域。结论抗生素对呼吸系统疾病的处方率因地区而异，与所选呼吸系统疾病的诊断率密切相关。

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