Table of Contents
ISRN Emergency Medicine
Volume 2014, Article ID 461258, 5 pages
Research Article

Antibiotic Prescriptions for Upper Respiratory Infection in the Emergency Department: A Population-Based Study

1Emergency Department, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei City 111, Taiwan
2School of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan
3Emergency Department, Buddhist Tzu Chi Dalin General Hospital, No. 2 Minsheng Road, Chiayi 622, Taiwan
4School of Medicine, Tzu Chi University, Hualien City 970, Taiwan
5Department of Public Health, National Taiwan University, Taipei City 106, Taiwan
6Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei City 112, Taiwan
7Department of Otolaryngology, Buddhist Dalin Tzu Chi General Hospital, Chiayi 622, Taiwan
8Cancer Center, Buddhist Dalin Tzu Chi General Hospital, Chiayi 622, Taiwan

Received 16 November 2013; Accepted 27 January 2014; Published 10 March 2014

Academic Editors: L. B. Mellick, R. Pitetti, and R. F. Sing

Copyright © 2014 Sheng-Wen Hou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Study Objective. Antibiotics prescriptions for upper respiratory infections (URI) are not uncommon, but the benefits for these groups had seldom been evaluated. We aimed to utilize a sampled National Health Insurance (NHI) claims data containing one million beneficiaries to explore if the use of antibiotics could reduce the possibility of unscheduled returns. Methods. We identified patients presented to ambulatory clinics with the discharged diagnoses of URI. The prescriptions of antibiotics were identified. We further matched each patient in the antibiotic group to the patient in the control group by selected covariates using a standard propensity score greedy-matching algorithm. The risks of unscheduled revisits were compared between the two groups. Results. A total of 6915140 visits were identified between 2005 and 2010. The proportions of antibiotics prescriptions are similar among these years, ranging from 9.99% to 13.38 %. In the propensity score assignment, 9190 patients (4595 in each group) were further selected. The odds ratio of unscheduled revisits among antibiotics group and control group was 0.92 (95% CI, 0.70–1.22) with value equal to 0.569. Conclusions. Overall, antibiotics prescriptions did not seem to decrease the unscheduled revisits in patients presented to the ED with URI. Emergency physicians should reduce the unnecessary prescriptions and save antibiotics to patients with real benefits.