OBJECTIVES: NICE clinical guidelines recommend no or delayed use of antibiotics in upper respiratory tract infections (URTI), while immediate use is only recommended in severe cases or where there is risk of developing complications. The primary objective of this study was to understand the antibiotic prescribing pattern during acute episodes of URTI. The secondary objective was to study the resource use during acute episodes of URTI.

METHODS: A retrospective database analysis was conducted using Dubai Claims Database. All outpatient claims between Jan 2014 to Mar 2017 with a diagnosis for an URTI, specifically acute otitis media, pharyngitis/tonsillitis and common cold, were extracted. All episodes of URTI were identified as a 15-day period from the date of index URTI diagnosis. The index URTI diagnosis date for each episode was identified such that there were no claims for an URTI during prior 15 days. The unit of analyses was the number of URTI episodes.

RESULTS: A total of 2,286,563 URTI episodes were identified, of which majority were for pharyngitis (42.2%) followed by common cold (32.2%), tonsillitis (19.7%) and acute otitis media (5.9%). Overall antibiotic was not used in 44.3% of the episodes, with highest for common cold (58.7%) and lowest for tonsillitis (29.9%). Of the remaining 55.7% of episodes where an antibiotic was prescribed, delayed prescribing (days 5-15 from diagnosis) was observed in 6.7% episodes. The average time to antibiotic from diagnosis was 1.7 days (SD 2.2, median 1.0). Use of multiple antibiotics was observed in 39.8% episodes.

CONCLUSIONS: No use of antibiotics was observed in less than half of the acute URTI episodes. Episodes where antibiotics were prescribed, delaying its use was less common.