Distribution and Reasons for Antibiotic Use in Prior 30 Days

Objectives: To assess the distribution of antibiotic prescriptions based upon select diagnoses.
Methods: Data from 6449 adults participating in the 2013-2016 National Health and Nutrition Examination Survey (NHANES) were used. All statistical analyses were weighted and population-adjusted to assess the relationship between key demographic and health characteristics, and antibiotic receipt in the past 30 days. Antibiotics and diagnoses were categorized according to the Anatomical Therapeutic Chemical (ATC) and the International Statistical Classification of Disease and Related Health Problems-10 (ICD-10), respectively. Diagnoses were grouped into 4 categories (Dental, Urogenital, Respiratory, and Other) based upon frequency of distribution.
Results: Approximately 7% (>9 million) of adults used an antibiotic prescription in the past 30 days. Among those receiving an antibiotic, 51.6% were women, 69.7% were non-Hispanic White, 64.9% were non-poor, and 65.0% had private health insurance. Approximately 2.3% of adults who had taken an antibiotic had neither a recent medical visit nor a dental visit. Almost 32.6% of individuals who used an antibiotic had a recent medical visit but no dental visit and 62.3% of individuals with an antibiotic had both a recent medical and dental visit. Reasons for antibiotic receipt were: Dental 16.0%; Urogenital 15.3%; Respiratory 28.5%, and other diagnoses 40.2%. Of those receiving antibiotics for a dental diagnosis, 63.2% had more than a high school education and 58.3% had private health insurance. Nearly 80.0% with a respiratory diagnosis and 67.4% with a urogenital diagnosis had more than high school education.

Conclusions: Dental, urogenital, and respiratory diagnoses represent nearly 60% of reasons for antibiotic receipt. There are important differences in antibiotic receipt by socio-demographic indicators (i.e., gender, race, and education). Understanding factors that explain antibiotic receipt could inform monitoring practices leading to improved antibiotic stewardship.