New Letter Finds Urgent Care Visits Commonly Result in Inappropriate Antibiotic and Glucocorticoid Prescription

A new letter published in the Annals of Internal Medicine found that “urgent care visits commonly result in inappropriate prescriptions of antibiotics, glucocorticoids, or opioids.”

Researchers examined commercial and Medicare Supplemental databases to study over 22 million urgent care visits; 12.4%, 9.1%, and 1.3% of these visits resulted in antibiotic, glucocorticoid, and opioid prescriptions respectively. They identified “a substantial number of prescriptions that were filled despite being ‘never appropriate’ or ‘generally inappropriate’ given the patients’ diagnoses.”

Of the “never appropriate” indications, “antibiotics were prescribed for 30.7% of patients diagnosed with otitis media, 45.7% with genitourinary symptoms, and 15.0% with acute bronchitis.” Previous studies showed “high rates of inappropriate prescriptions for respiratory tract infections.”

The researchers specifically cited one study that found “inappropriate antibiotic prescribing in 16% of urgent care visits, compared to 6% and 5% in office and emergency visits, respectively.” Glucocorticoids were prescribed inappropriately in “23.9% of sinusitis, 40.8% of acute bronchitis, and 7.9% of otitis media cases,” and urgent care centers “prescribed opioids in a variety of generally inappropriate cases, including non-back musculoskeletal pain (4.6% of cases), abdominal pain and digestive symptoms (6.3%), and sprains and strains (4.0%).”

The authors of the letter suggest “a variety of potential solutions, including drug stewardship programs, electronic health record programs, and education.”