Amoxicillin Penicillin‑class β‑lactam antibiotic Similar indications as Augmentin but without clavulanate; useful when β‑lactamase production is unlikely
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2. Key Pharmacology
Drug Mechanism of Action Spectrum (typical) Major Indications
Amoxicillin Inhibits bacterial cell wall synthesis by binding penicillin‑binding proteins (PBPs). Broad spectrum against gram‑positive cocci & rods, some gram‑negative rods; active vs. Streptococcus, H. influenzae (non‑β‑lactamase), Neisseria. Otitis media, pharyngitis, sinusitis, pneumonia, dental infections.
Amoxicillin + Clavulanate Same as above; clavulanate inhibits β‑lactamases, extending activity to β‑lactamase–producing organisms (e.g., H. influenzae). Same spectrum plus β‑lactamase producers. Similar indications, especially when resistance suspected.
Cefdinir 3rd‑generation cephalosporin; broad activity against gram‑positive cocci and some gram‑negative rods. Effective for acute bacterial rhinosinusitis (sinus infections).
Azithromycin Macrolide antibiotic; covers atypical pathogens like Mycoplasma pneumoniae, Chlamydophila pneumoniae, and common bacteria (Streptococcus pneumoniae). Often used when patient cannot tolerate macrolides or in cases of suspected atypical infection.
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2. Antibiotic‑Prescribing Rate (2009‑2023)
Overall rate: ~30–35% of adults with acute respiratory complaints receive an antibiotic.
Trend: Decline from ≈38% in 2009 to ≈31% in 2023, but rates remain above the CDC target of <20%.
3. Key Factors Associated With Antibiotic Prescribing
Factor Impact on Prescribing
Patient Age – Older adults (>65) are more likely to receive antibiotics. ↑
Sex – Females tend to receive antibiotics slightly less frequently than males. ↓
Race/Ethnicity – Minorities (especially Black and Hispanic patients) have higher odds of receiving antibiotics. ↑
Insurance Status – Patients with private insurance or Medicaid are more likely to be prescribed antibiotics compared with uninsured patients. ↑
Provider Specialty – Family physicians, internists, and general practitioners prescribe antibiotics at higher rates than specialists (e.g., dermatologists). ↑
Clinical Setting – Outpatient primary care visits see higher antibiotic prescribing rates than urgent‑care or emergency settings. ↑
Geographic Region – The southern United States has the highest antibiotic prescription volumes; the Pacific Northwest has the lowest. ↑
These factors are consistently identified in national studies of antibiotic use (e.g., CDC’s Antibiotic Resistance Patient Safety Network, Institute for Health Metrics and Evaluation analyses, and peer‑reviewed surveys). They illustrate how both patient‑level variables (age, comorbidities) and system‑level drivers (provider practice patterns, regional culture) influence the likelihood that an individual will receive a prescription. Understanding these determinants is essential for designing targeted stewardship interventions that reduce unnecessary antibiotic use while preserving access for patients who truly need them.
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