Non–First-Line Antibiotics Are Prescribed Commonly for Respiratory Infections

In response to increasing concerns about antibiotic resistance, researchers used data from the National Ambulatory Medical Care Survey to identify antibiotic prescription choices made by physicians during 5527 office visits (adult and pediatric) for otitis media, sinusitis, and pharyngitis in 2010 and 2011; only visits in which antibiotics actually were prescribed were considered. According to national guidelines for patients with no drug allergies and first-time uncomplicated visits, first-line recommendations for otitis media and sinusitis are amoxicillin or amoxicillin-clavulanate; for pharyngitis, first-line recommendations are penicillin or amoxicillin. For each visit, the actual prescribed antibiotic was rated as first-line or non–fir…