SYSTEMATIC REVIEW article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1533797
Prevalence and Healthcare Burden of Inappropriate Antimicrobial Treatment in Patients at High Risk of Complications from Acute Respiratory Infections: A Scoping Review
Provisionally accepted
- 1Premier Inc, Charlotte, United States
- 2bioMerieux, Salt Lake City, Utah, United States
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Background: Evidence of inappropriate antimicrobial treatment for acute respiratory infections (ARIs) is well-established in literature. However, comprehensive evaluations of inappropriate antimicrobial use and associated clinical and economic outcomes for patients at high risk of complications from ARIs are lacking. This scoping review described the prevalence of inappropriate antimicrobial use and its healthcare burden in this patient population.Material and methods: We queried Medline and CINAHL databases using keywords related to antimicrobials for ARIs in high-risk patients, and included U.S. studies reporting prescribing patterns, outcomes, adverse events, and costs.Results: Our search yielded 3,383 studies after de-duplication, from which 482 were selected for full-text evaluation based on exclusion criteria, resulting in 32 papers analyzed that included relevant information on high-risk populations. The analysis suggested that patients at high risk for complications experience improper prescribing of antimicrobials for ARIs, which is associated with higher direct and indirect costs, increased health care resource utilization, higher incidence of adverse events, and more severe disease complications.Conclusions: Areas for improving care for this patient population include identifying patients at risk of severe disease and complications from ARIs and following evidence-based protocols for testing, treatment and follow-up to minimize the risk of developing adverse events, antibiotic-resistance, and severe complications.
Keywords: Acute respiratory infection, disease burden, High risk patients, Risk factors, Burden Of Illness
Received: 24 Nov 2024; Accepted: 18 Apr 2025.
Copyright: © 2025 Polacek, Timbrook, Cui, Heins and Rosenthal. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ning An Rosenthal, Premier Inc, Charlotte, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.