Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025
Collaboration to harmonize antimicrobial registry measures (CHARM) database analysis of antibiotic prescribing in urgent and non-urgent care: a retrospective study on demographic factors.
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Vo Tan, Dahal Kushal, Klepser Michael, Pontefract Benjamin, Caniff Kaylee E, Sohn Minji
Аннотация
OBJECTIVE: To compare demographic patterns, diagnosis distribution, and prescribing trends between urgent care and non-urgent care clinics for infectious disease encounters across age groups.
DESIGN: Retrospective cross-sectional study.
SETTING: Outpatient encounters from 93 facilities (7 urgent care, 86 non-urgent clinics) in a single Michigan health system, from January 2021 to December 2024.
PARTICIPANTS: A total of 161,328 outpatient encounters involving an antibiotic prescription. Data were stratified by age group, sex, race, insurance type, and care setting.
METHODS: Antibiotic prescription and ICD-10 diagnosis data were extracted from the CHARM database and compared across settings using χ2, Fisher's exact, and Mann-Whitney tests.
RESULTS: Urgent care encounters involved younger patients (median age 45 vs 55 yr, p < .001), with more visits among children aged 0-5 years (9.0% vs 5.3%, p < .001). Non-urgent care encounters had more patients aged ≥ 60 years (43.8% vs 34.1%, p < .001). Upper respiratory tract infections (URTIs), including acute pharyngitis and otitis media, were more frequent in urgent care (15.0% and 11.9% vs 6.7% and 7.6%, p < .001). Urinary tract infections (UTIs) were more common in non-urgent care (15.2% vs 13.8%, p < .001). Amoxicillin was the most prescribed antibiotic in urgent care (17.4% vs 11.4%, p < .001), while cephalexin led in non-urgent care (13.5% vs 11.5%, p < .001).
CONCLUSIONS: Comparatively, a larger proportion of urgent care visits were for patients under the age of 18 and for patients with URTIs. Meanwhile, a greater proportion of non-urgent care encounters were for patients over the age of 60 years old and patients with unspecified UTI.
DESIGN: Retrospective cross-sectional study.
SETTING: Outpatient encounters from 93 facilities (7 urgent care, 86 non-urgent clinics) in a single Michigan health system, from January 2021 to December 2024.
PARTICIPANTS: A total of 161,328 outpatient encounters involving an antibiotic prescription. Data were stratified by age group, sex, race, insurance type, and care setting.
METHODS: Antibiotic prescription and ICD-10 diagnosis data were extracted from the CHARM database and compared across settings using χ2, Fisher's exact, and Mann-Whitney tests.
RESULTS: Urgent care encounters involved younger patients (median age 45 vs 55 yr, p < .001), with more visits among children aged 0-5 years (9.0% vs 5.3%, p < .001). Non-urgent care encounters had more patients aged ≥ 60 years (43.8% vs 34.1%, p < .001). Upper respiratory tract infections (URTIs), including acute pharyngitis and otitis media, were more frequent in urgent care (15.0% and 11.9% vs 6.7% and 7.6%, p < .001). Urinary tract infections (UTIs) were more common in non-urgent care (15.2% vs 13.8%, p < .001). Amoxicillin was the most prescribed antibiotic in urgent care (17.4% vs 11.4%, p < .001), while cephalexin led in non-urgent care (13.5% vs 11.5%, p < .001).
CONCLUSIONS: Comparatively, a larger proportion of urgent care visits were for patients under the age of 18 and for patients with URTIs. Meanwhile, a greater proportion of non-urgent care encounters were for patients over the age of 60 years old and patients with unspecified UTI.