Frequency of Inappropriate Antibiotic Use

Assessed appropriateness of antibiotic use in about 184,000 ambulatory visits (not including urgent cares, federal or long-term facilities) in 2010-2011 using accepted clinical guidelines.
If guidelines not available (e.g., sinusitis), lowest regional level of abx use used as surrogate.
Overall rate of abx Rx was 506 / 1000 people.
2/3 were appropriate (353/1000)
Most inappropriate antibiotic use was for acute URIs (111/1000 people annually).
Summary:  A 50% reduction in inappropriate abx use could be achieved by eliminating Rx for acute URIs.
This drop would still leave us with 400 Rx / 1000 people, higher than Sweden (328/1000) which has very low resistance rate.
JAMA 2016 May 3; 315:1839
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