Antibiotic Prescribing Patterns for Acute Sinusitis in Nova Scotian Adults

Abstract

Background: This study describes antibiotic prescribing and practice variation in outpatient settings using a condition commonly resulting in antibiotic therapy, acute sinusitis. Methods: I conducted a 24-month retrospective cross-sectional study analyzing outpatient antibiotic use for acute sinusitis in adults across Nova Scotia using administrative data. Using descriptive statistics and random effects logistic regression models, association of a diagnosis of acute sinusitis with antibiotic prescribing and duration of antibiotic therapy were investigated. Results: Antibiotics were prescribed at 62.3% of encounters, and 42.3% were likely unnecessary. Models indicate substantial between-provider heterogeneity in antibiotic prescribing and duration of therapy for acute sinusitis. Four percent of providers achieved the recommended prescribing rate (<= 20%). 71.3% of dispensed antibiotic prescriptions were longer than recommended. Interpretation: Unnecessary antibiotic prescribing for acute sinusitis was common and most of the variability in prescribing rates was due to individual provider differences. A multifaceted stewardship approach could improve prescribing rates.