Criteria for inappropriate antibiotic prescription:
(1) Prescribing a second or third line antibiotic to treat an infection.
(2) Prescribing an antibiotic to treat an infection with a high probability of being caused by a virus.
where:
• Selection of a second or third line antibiotic may be appropriate if there are contraindications to all first-line antibiotics.
• Several other factors are conspicuously absent - using an antibiotic when there are contraindications to its use, wrong dose, inadequate duration, etc.
Risk factors associated with inappropriate antibiotic prescription:
(1) high practice volume
(2) non-US foreign medical graduate
(3) longer time in practice
where:
• The relative risk for these factors were 1.8 or less, which are pretty weak.
• A provider may become comfortable with certain antibiotics. S/he will tend to use these over the years despite introduction of better agents or the emergence of resistant strains.
