Use of c tlmicrobial % in Offke= Based Practke unitedStates, 1-1 Data on the use of antimicrobial drugs during Offb visitstodk—bSSd physicians are presented. Emphask is placed on the types of drug used: peniallins, cephatosporins, macroliis and Iincosamides, tetraoyctks, the sulfonamides andkw trimethoptim, and miscellaneous antimicrobial medications. The level of use of the various types of drug is assessed by comparing drug mention frequencies and rates. The characteristics of the drugs used afso are investigated. Various aspects of the visits involving the use of these drugs are examined. These include the demogrephii characteristics of the patients who made the visits, patient complaints, dwnoees recoded, d~nostic and therapeutic sentices ordered or provided, patient disposMon, and visit duration. Dsts Ffomthe Nstiond H8elth Sunfey series Iq No. 8s DHHS Publiition No. (PHS) 86-1746 U.S. Department of Health and Human services PubIii Heanh service National Center for Health Statistics Hyattsville, Md. June 19S6 I Copyright Information The National Center for Health Stabs.tics has obtained permission from the copyright holders to reproduce ceriam quoted material in this report. Further reproduction of this material is prohibited without specific permission of the copyright holders. All other material contained in the reporl is in the public domain and may be used and reprinted without special permission; citation as to source, however, is appreciated. Suggested Citatiin National Center for Health Statistics, G. J. Gardocld: Use of antimicrobial drugs in office-based practice, United States, 1980-61. Vita/ and Hea/th Statistics. Series 13, No. 85. DHHS Pub. No. (PHS) 86-1746. Public Health Service Washington. U.S. Government Printing Gffice, June 1988. L~ry 01 Congress Cataloging-in~ Data Gardocld, Gloria J. Use of antimicrobial drugs in office-baaed practice. (Vital & health statistics. Series 13, Data from the national health survey; no. 85) (DHHS publication; (PHS) 66-1746) Author: Gloria J. Gardocki. Bibliography: p. $upt. of D~s. no.: HE20.6209:13/85 1. Drug utlltzatior+Unitad Statee-Statistics. 2. Anti-infective agente- Thera@utic usa-+tetktics. 3. Physician services utiliiatiin-Unitad States- Statistics. 1. National Center for Health Statiafks (U. S.) Il. Ttle. Ill. Vial and health statistics. series 13, Data from the national health suwey; no. 65. IV. Series: DHHS puMkation; no. (PHS) 6$-1746. [DNLM: 1. Anti-lnfaotive Agents+harapautic uflnitad Statea--atatistics. 2. Diug Utilization-United States-statistics. 3. Gffii Visits-United Statea-+teMca. W2 A NI 46vm no. 65] RM261 .3.U6G37 1966 61 S.329 66-60Wt29 ISBN 0-6406+331-2 lTor sale by the Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402 National Center for Health Statistics Manning Feinleib, M. D., Dr. P. H., Director Robert A. Israel, Deputy Director Jacob J. Feldman, Ph. D., Associute Director for Anulysis und Epidemiology Garrie J. Losee, Associute Director for Dutu Processing and Services Alvan O. Zarate, Ph. D., Assistant Director for international Statistics Peter L. Hurley, Acting Associute Director for Interview und Examination Statistics Stephen E. Nieberding, Associute Director for Management Gail F. Fisher, Ph. D., Associate Direclor for Program Planning, Evaluation, and Coordination Monroe G. Sirken, Ph. D., Associate Director for Research and Methodology Peter L. Hurley, Associate Director for Vital and Health Cure Statistics Alice Haywood, Information 0J7icer Vital and Health Care Statistics Program Peter L. Hurley, Associate Director Gloria Kapantais, Assistant to the Director for DUIUPolicy, Planning, and Analysis Division of Health Care Statistics W. Edward Bacon, Ph. D., Director Joan F. Van Nostrand, Deputy Director James E. Deiozier, Chief, Ambulatory Care Statistics Branch Introduction . ..l Information highlights . ........2 Data background . -. ...-..4 Scope of the report . 4 Data source and limitations.. -...--..4 Selection and classification of antimicrobial drugs . 5 Findings . - - ...--..10 Dmgmention information . - . - . - - . 10 Visit information . - . ...15 References . -....-.30 List of detailed tables . .. ...--.31 Appendmes , I. Technical notes . ...42 11. Definitions of certain terms used in this report . 49 111.Patient Log and Patient Record form . ...52 IV. American Hospital Formulary Service classification system and therapeutic categov codes . 53 Iistoftextfigures 1. Classification of antimicrobial generic entities appearing in the National Ambulatory Medical Care Survey: United States, 1980-81 ..-.-.. .. 6 2. Drugs named by physician respondents in reporting the order or provision of ’wnicillins: United States, 1980-81 . .................. ....” 7 3. Drugs named by physician respondents in reporting the order or provision of cephalosporins: United States, 1980-81 . .......”.....”..... .. 7 4. Drugs named by physician respondents in reporting the order or provision of macrolides and Iincosamides: United States, 1980-81 . .....-.......”...-. .. 7 5. Drugs named by physician respondents in reporting the order or provision of tetracycline: United States, 1980-81 . ..-. ................... .’ 8 6. Dregs named by physician respondents in reporting the order or provision of sulfonamides and trimethoprim: United States, 198(k81 . -. 8 7. Drugs named by physician respondents in reporting the order or provision of miscellaneous antimicrobial: United States, 1980-81 . .- 9 List of text tsbles A. Number and percent distribution of antimicrobial drug mentions, by type of antimicrobial drug: United States, 198&81 . ................... .- 10 B. Number and percent distribution of the 20 generic ingredients most frequently appearing in antimicrobial drug mentions: United States, 1980-81 . 11 C. Number and percent distribution of the 30 antimicrobial drugs most frequently mentioned in office-based practice: United States, 1980-81 . .....12 .. w D. Number and percent distribution of antimicrobial drug mentions, by American Hospital Formulary Service therapeutic category : United States, 1980-81 . 12 E. Number and percent distribution of antimicrobial drug mentions by composition status, according to type of antimicrobial drug: United States, 1980-81 . 13 F. Number and percent distribution of antimicrobial drug mentions by entry status, according to type of a,nti- microbial drug: United States, 1980-81 . 13 G. Number, percent distribution, and average annual rate (per 1,000 civilian noninstitutionalized population) of antimicrobial drug mentions by sex and age of patient, according to type of antimicrobial drug: United States, 198&81 . 14 H. Number and percent distribution of antimicrobial drug visits, by type of antimicrobial drug ordered or provided: United States, 1980--8l. 15 J. Number and percent distribution of antimicrobial drug visits by major reason for visit, according to type of antimicrobial drug ordered or provided: United States, 1980-81 . 16 K. Number and percent distribution of the 20 specific principal reasons for visit most commonly given during antimicrobial drug visits: United States, 198&81 . 16 L. Number and percent distribution of antimicrobial drug visits, by class of principal diagnosis: United States, 198W81 . 17 M. Number and percent distribution of the 20 specific principal diagnoses most commonly made during anti- microbial drug visits: United States, 1980-81 . 17 N. For visits associated with each type of antimicrobial drug, number and percent distribution of the most common specific principal diagnoses: United States, 1980-81 . 18 0. Number of all visits, number of antimicrobial drug visits, antimicrobial drug visits as a percent of all visits, and the most frequently mentioned types of antimicrobial drug, for each of the 20 principal diagnoses most commonly made during antimicrobial drug visits: United States, 1980-81 . 20 P. Number of all new-problem and return visits and percent of new-problem and return visits involving antimicrobial, for each of the 20 principal diagnoses most commonly made during antimicrobial drug visits: United States, 198@81 . 21 Q. Number, percent distribution, and average annual rate (per 1,000 civilian noninstitutionalized population) of antimicrobial drug visits by sex and age of patient, according to type of antimicrobial drug ordered or provicled: United States, 1980-81 . 22 R. Median age of patients making antimicrobial drug visits, by type and selected subtype of antimicrobial drug ordered orprovided: United States, 1980-81 . 23 S. Number and percent distribution of antimicrobial drug visits by physician specialty, according to type of antimicrobial drug ordered or provided: United States, 1980-81 . 24 T. Number and percent of antimicrobial drug visits, by type of antimicrobial drug ordered or provided and diagnostic service ordered or provided: United States, 1980-81 . 25 U. Number and percent of antimicrobial dmg visits, by type of antimicrobial drug ordered or provided and nonmedication therapeutic service ordered or provided: United States, 1980-81 . 26 W. Average number of co-occurring medications per antimicrobial drug visit, by type of antimicrobial drug ordered or provided and sex and age of patient United States, 1980-81 . 27 Y. Number and percent distribution of co-occurring drugs ordered or provided during antimicrobial dmg visits by therapeutic category of co-occurring dreg, according to type of antimicrobial drug ordered or provicled United States, 198&81 . 28 Z. Number and percent distribution of the 10 co-occurring drugs most