Avoidance of Antibiotic Use

Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis*

HEDIS®1 Measure: The percentage of adults 18-64 years of age with a diagnosis of acute bronchitis who were not dispensed an antibiotic prescription.

Antibiotics are most often inappropriately prescribed for healthy 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 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 children 3 months to 18 years of age who were given a single diagnosis of URI and were not dispensed an antibiotic prescription within 3 days of URI diagnosis.

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 children 2-18 years of age who were diagnosed with pharyngitis, dispensed an antibiotic and received a group A streptococcus (strep) test for the episode. A higher rate represents better performance (ie. appropriate testing).

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) (2014): Healthcare Effectiveness Data and Information Set (HEDIS) 2015. Volume 1.

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