Avoidance of Antibiotic Use

Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis*

HEDIS®1 Measure: The percentage of episodes for members ages 3 months and older with a diagnosis of acute bronchitis/bronchiolities that did not result in an antibiotic dispensing event.

Antibiotics are most often inappropriately prescribed for children and adults with bronchitis. This is of clinical concern because the misuse and overuse of antibiotics lead to antibiotic resistance. Antibiotics are not indicated in clinical guidelines for treating children and adults with acute bronchitis who do not have a comorbidity or other infection for which antibiotics may be appropriate.

Appropriate Treatment of Children with Upper Respiratory Infections*

HEDIS® Measure: The percentage of episodes for members 3 months of age and older with a diagnosis of upper respiratory infection (URI) that did not result in an antibiotic dispensing event.

The common cold (or URI) is a frequent reason for children visiting the doctor’s office. Though existing clinical guidelines do not support the use of antibiotics for the common cold, physicians often prescribe them for this ailment. Pediatric clinical practice guidelines do not recommend antibiotics for the majority of upper respiratory tract infections due to viral etiology of these infections, including the common cold.*

Appropriate Testing for Children with Pharyngitis*

HEDIS® Measure: The percentage of episodes for members 3 years and olderwhere the member was diagnosed with pharyngitis, dispensed and antibiotic and received a group A streptococcus (strep) test for the episode.

Pharyngitis is the only condition among upper respiratory infections (URI) where a diagnosis is easily and objectively validated through administrative and laboratory data, and it can serve as an important indicator of appropriate antibiotic use among all respiratory tract infections. Pediatric clinical practice guidelines recommend that only children with diagnosed group A streptococcus (strep) pharyngitis, based on appropriate lab tests, be treated with antibiotics.*

Physician Resources

Educational Patient Handouts

For more information contact Quality Improvement.

Quality Improvement Phone: 757-252-8400 or 1-844-620-1015


*Source: National Committee for Quality Assurance (NCQA) (2019): Healthcare Effectiveness Data and Information Set (HEDIS) 2020. Volume 2.

1 HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).