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Despite ongoing education and stewardship programs, inappropriate antibiotic prescribing is still common in high-income countries, especially for respiratory illnesses. A review of 12 observational studies from primary care settings in the United States, Europe, and Asia between 2021 and 2025, published in Cureus, found that when analyzing prescribing patterns by category, respiratory tract visits contributed to the largest overall share of inappropriate prescriptions—even when their rate of inappropriate antibiotic prescribing was not the highest. Reported rates ranged from 10.9%–80.5%, with U.S. studies showing that 42.2%–55.7% of upper respiratory tract visits resulted in inappropriate antibiotic prescriptions. Bronchitis was the diagnosis most consistently associated with unnecessary antibiotics overall. High rates of inappropriate prescribing also were reported for nonspecific clinical presentations—at least 2 studies reported rates up to 100%. Amoxicillin-clavulanate was the most prescribed agent, according to the authors. In terms of individual clinicians, inappropriate prescribing was associated with male sex, older age, lower educational level, and—surprisingly—greater clinical experience.
Urgent care prescribing patterns: In urgent care, about 15% of acute bronchitis visits resulted in a “never appropriate” prescription for antibiotics, according to a separate study of 22 million urgent care visits from 2018 to 2022, published last year. Read more about the study and the need for more data and research in urgent care from the JUCM archive: Urgent Care’s Use of Antibiotics, Glucocorticoids, Opioids Not Always Appropriate