The authors were interested in the extent that outpatient antibiotic prescribing for acute upper respiratory tract infections (URTIs) is occurring for patients with cancer. They conducted a retrospective cohort study of adult patients at an ambulatory cancer centre with ICD-10 diagnosis codes consistent with URTI between 2015–2016. They examined antimicrobial prescribing, respiratory viral testing and other clinical data at the first clinical encounter and through to day 14. Of 341 charts reviewed, 74% of patients were eligible for analysis. 32% of patients were prescribed antibiotics for URTI. Respiratory viruses were detected among 75% of the 113 patients tested. The authors found that antibiotic prescribing and viral testing were significantly different between clinical services. Productive coughs or chest congestion was associated with a significantly higher risk of antibiotic prescribing (relative risk [RR] 2.3, 95%CI 1.4-3.8). Viral testing on day 0 was associated with a significantly lower risk of antibiotic prescribing (RR 0.4, 95%CI 0.2-0.8), but collinearity between viral testing and clinical service made it difficult to separate the effect of these two on prescribing. Antibiotic prescribing was not associated with subsequent URTI-related healthcare visits. Therefore nearly one-third of haematology-oncology outpatients were prescribed antibiotics for URTI, despite viral aetiologies identified among 75% of those tested.
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