Factors Affecting the Decision to Prescribe Antibiotics in the Emergency Department

Background: The aim of this study was to detect the factors affecting physician's decisions to prescribe antibiotics for patients presenting to our hospital's emergency department (ED) with symptoms of infectious disease. Methods: This retrospective observational survey included the data of patients who presented to the ED with symptoms of infectious disease between January 1, 2014, and June 30, 2014. Statistical analysis was performed with SPSS version 22.0. P <0.05 was accepted as statistically significant. Results: A total of 3,098 patients had symptoms relevant to infectious disease; 2,171 (70.1%) of them were male, and the mean age was 21 years (range 0?88). The most frequent symptom was sore throat (38.8%), and the most frequent initial diagnosis was acute pharyngitis (45.9%). The complete blood count (29.8%) was the most commonly used laboratory test. Of the treatments, 2,103 (86.2%) were empirical and 337 (13.8%) were laboratory-assisted. No culture-supported treatments were encountered. Antibiotics were included in 1,351 (64.2%) of the empirical treatments and in 252 (74.8%) of the laboratoryassisted treatments. It was identified that high fever, chest x-ray requests, signs of infection in stool, signs of infection on urinalysis, and leukocytosis affected the physicians' decisions to prescribe antibiotics (p <0.001, p <0.001, p <0.001, p <0.001, p= 0.019, respectively). Conclusion: High fever, chest x-ray requests, signs of infection in stool or on urinalysis, and leukocytosis significantly affected physicians' decisions to prescribe antibiotics in the ED.