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Laryngoscope. 2015 Oct;125(10):2266-72. doi: 10.1002/lary.25363. Epub 2015 May 22.

Diagnosis and treatment of acute sinusitis in the primary care setting: A retrospective cohort.

Author information

1
Department of Otolaryngology.
2
Michigan Institute for Clinical and Health Research.
3
Department of Pediatrics and Communicable Diseases, Department of Internal Medicine, University of Michigan Medical School; Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor, Michigan, U.S.A.

Abstract

OBJECTIVES AND HYPOTHESIS:

Our objectives were to characterize the quality of acute sinusitis care and to identify nonclinical factors associated with antibiotic use for acute sinusitis. We hypothesized that we would identify provider-level factors associated with antibiotic use.

STUDY DESIGN:

Retrospective cohort at a single academic institution.

METHODS:

We developed and clinically annotated an administrative dataset of adult patients diagnosed with acute sinusitis between January 1, 2005, and December 31, 2006. We used identify factors associated with receipt of antibiotics.

RESULTS:

We find that 66.0% of patients with mild symptoms of short duration are given antibiotics, and that nonclinical factors, including the individual provider, the provider's specialty, and the presence of a medical trainee, significantly influence antibiotic use. Relative to internal medicine providers, family medicine providers use fewer antibiotics, and emergency medicine providers use more antibiotics for acute sinusitis.

CONCLUSIONS:

Antibiotics continue to be overused for patients with mild acute sinusitis of short duration. Nonclinical characteristics, including the individual provider, the provider's specialty, and the presence of a medical trainee, significantly influence use of antibiotics for acute sinusitis.

LEVEL OF EVIDENCE:

4.

KEYWORDS:

Sinusitis; adult; provider; retrospective cohort; survey

PMID:
26010534
PMCID:
PMC4578987
DOI:
10.1002/lary.25363
[Indexed for MEDLINE]
Free PMC Article

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