The who, where, and what of outpatient antibiotics for COVID-19

Reviewed by Hannah Imlay, MD, MS; University of Utah

The authors characterized antibiotic prescribing in older adults with outpatient COVID-19 visits and identified demographic groups (non-Hispanic White patients) and healthcare settings (ED and telehealth visits) where antibiotics were being inappropriately prescribed. Using Medicare claims, procedural terminology codes, ICD-10 codes, and place-of-service codes, visits with a primary diagnosis of COVID-19 and no other diagnosis that could warrant antibiotics were selected, and characteristics of patients and healthcare setting were assessed. From April 2020-April 2021, 346,204 of 1,169,120 (30%) of COVID-19 outpatient visits were associated with an antibiotic prescription. Areas of highest prescribing were in the ED (33%), followed by telehealth visits (28%). Since telehealth is a growing mode of healthcare delivery, this is an area for future stewardship interventions. Non-Hispanic White beneficiaries received antibiotics more frequently (30%) than other racial or ethnic groups (23-28%).

Tsay SV, Bartoces M, Gouin K, Kabbani S, Hicks LA. Antibiotic Prescriptions Associated With COVID-19 Outpatient Visits Among Medicare Beneficiaries, April 2020 to April 2021. JAMA. 2022;327(20):2018–2019. doi:10.1001/jama.2022.5471

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