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From the Department of Family Medicine, Kansas City University of Medicine and Biosciences College of Osteopathic Medicine, Kansas City, Mo.

Address correspondence to: Chao Sun, MD, MPH, Department of Family Medicine, University of Health Sciences College of Osteopathic Medicine, 1750 Independence Ave, Kansas City, MO 64106-1453. E-mail: csun{at}uhs.edu

Objective: To assess factors related to prescribing antibiotics for nonspecific upper respiratory tract infections (URTIs) by office-based osteopathic physicians.

Methods: Retrospective analysis of physician office visits by patients with URTIs, using the National Ambulatory Medical Care Survey database for a 5-year period. Antibiotic prescribing was analyzed based on patient and physician characteristics. Multiple logistic regression modeling was then used to assess the independent contribution of these factors.

Results: Between July 1, 1997, and June 30, 2001, there were 9.6 million patient visits to osteopathic physicians for URTIs in the United States. Antibiotics were prescribed in 56.4% (5.41 million) of these visits. Adults, nonwhites, females, patients with a concurrent condition such as acute bronchitis, acute otitis media, acute pharyngitis, acute sinusitis, or asthma, and patients requiring additional medications for their symptoms were more likely to be given antibiotics. In addition, family physicians, physicians who were not owners of their practices, and those practicing in nonmetropolitan areas were more likely to prescribe antibiotics.

Conclusions: Antibiotics were prescribed in more than 4.8 million (50%) patient visits for URTIs. Greater efforts are needed to address some of the factors that influence prescribing practices.

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