2 million were adult uncomplicated URIs without any other concurrent diagnoses. Among all uncomplicated URI visits, about 52% (95% CI: 47-58%) had antibiotic prescriptions and 46% (95% CI: 40-52%) had X-ray. Less than 2% of the visits performed CT studies. Approximately 51% (95% CI: 46-57%) of these visits had a diagnosis of bronchitis, 35% (95% CI: 29-40%) had a diagnosis of URI NOS, 9% (95% CI: 5-10%) had nasopharyngitis, laryngitis or influenza, and 4% (95% CI: 2-7%) had multiple URI diagnoses. Figure1 reports the prescription rate of each antibiotic

class. About 36% (95% CI: 31-42%) of the visits included macrolide prescriptions, Inhibitors,research,lifescience,medical with the vast majority being azithromycin. Roughly 5% (95% CI: 3-8%) had penicillin prescriptions, Inhibitors,research,lifescience,medical almost all of which were amoxicillin and amoxicillin/clavulanate. Nearly 5% (95%

CI: 3-7%) prescribed quinolones, the most frequent being levofloxacin followed by moxifloxacin and ciprofloxacin. Approximately 4% (95% CI: 3-6%) used tetracyclines, almost all of which were doxycycline. Figure 1 Prevalence of antibiotic Inhibitors,research,lifescience,medical use. Descriptive statistics of the sample characteristics are shown in Table1. Table2 reports results from the multivariate analyses. Among statistically significant (p<0.05) findings, the diagnosis of bronchitis and multiple URI diagnoses were more likely than URI NOS to be associated with antibiotic prescriptions. In addition, the diagnosis of bronchitis was more likely than the diagnosis of URI NOS to be associated with the ordering of imaging studies. Among vital signs, fever was found to be significantly associated with a higher likelihood of prescribing antibiotics. Table 1 Descriptive Inhibitors,research,lifescience,medical statistics (n=616) Table 2 Results from multivariate

analyses (odds ratios)a (n=616) Waiting time longer than 2hours was significantly associated with increased odds of prescribing antibiotics. As compared with males, female patients were found to be less likely to get antibiotics. Middle-aged patients were more likely than their younger counterparts Inhibitors,research,lifescience,medical to MAPK Inhibitor Library cost receive imaging studies. Having private insurance or Medicare was significantly associated with imaging studies. MSA status was significantly associated with increased probabilities of receiving imaging until studies. Discussion In spite of research evidence and guidelines on the management of uncomplicated URIs, over-prescribing of antibiotics and imaging studies, particularly plain radiography, persists. In 2000, over half of all ED visits for URIs had an antibiotic prescribed [2]. In 2005–2006, the antibiotic prescription rate reach 64% of URI visits in EDs [5]. Our study offered another piece of evidence that the overutilization of antibiotics in EDs continued into 2008, despite the growing concerns for antibiotic resistance and rising health care costs. An early study reported that penicillins (13.1%), macrolides (25.8%), and cephalosporins (6.2%) were the most frequently prescribed antibiotics in 1995–2000 [1].