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Residents who receive care at an outpatient clinic are nearly three times as likely to be prescribed an inappropriate antibiotic, researchers at the University of Wisconsin-Madison have reported.

Using medical records from five nursing homes in southern Wisconsin, staff from the School of Medicine and Public Health studied prescribing patterns and origins for all residents given antibiotics for suspected lower respiratory tract infections, skin and soft tissue infections and urinary tract infections.

To determine whether the antibiotic was appropriate, the study depended on the Loeb criteria and the Chi-square test. The researchers reported in Antimicrobial Resistance & Infection Control that they found a significant difference in appropriate prescribing depending on condition. Patients with UTIs were 4.47 times more likely to get an inappropriate prescription.

In nursing homes, up to two-thirds of residents receive antibiotics each year and about one-quarter of those are estimated to be inappropriate.

Providers in outpatient clinics and emergency departments are both likely to overprescribe or wrongly prescribe if unfamiliar with a patient.