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Diagnosis and treatment of acute sinusitis in the primary care setting: A retrospective cohort
Author(s) -
Pynn Melissa A.,
Lynn Shana,
Kern Hayley E.,
Novis Sarah J.,
Akkina Sarah R.,
Keshavarzi Nahid R.,
Davis Matthew M.
Publication year - 2015
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.25363
Subject(s) - retrospective cohort study , medicine , primary care , cohort , sinusitis , intensive care medicine , emergency medicine , pediatrics , family medicine , surgery
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. Laryngoscope , 125:2266–2272, 2015