Research Activities, October 2013
Black children with acute respiratory infections receive fewer antibiotic prescriptions than non-black children
When treated by the same clinician, black children receive fewer antibiotic prescriptions for acute respiratory tract infections (ARTIs) than non-black children (23.5 vs. 29 percent), according to a new study. Also, when an antibiotic was prescribed, black children were less likely to receive broad-spectrum antibiotics at any visit, including visits for acute ear infections.
The researchers examined antibiotic prescribing patterns across a diverse network of 25 pediatric practices in 2009. Although this study did not investigate the reasons for these disparities, differences in prescribing rates might have been driven by differences in parental expectations, physician perception of parental expectations, and/or differential use of shared decisionmaking.
The contribution of practitioner bias to racial differences in diagnosing and treating ARTIs was unclear. Since ARTIs are common, have little variation in disease severity, and are generally managed within a single encounter by a clinician who manages hundreds of ARTIs per year, the researchers believe that these infections offer a clear opportunity to examine whether race affects the diagnosis and treatment decisions of individual providers.
The study included over 200,000 children seen by 222 clinicians in 25 practices during 2009. This study was funded by AHRQ (Contract No 290-07-10013).
See "Racial differences in antibiotic prescribing by primary care pediatricians," by Jeffrey S. Gerber, M.D., Priya A. Prasad, M.P.H., A. Russell Localio, Ph.D., and others in Pediatrics 131, pp. 677-684, 2013.