• This is a Healthcare Effectiveness & Data Information Set (HEDIS®) administrative measure and only includes Medicaid Primary beneficiaries.
• The annual reported rate captures activity during the stated measurement year (MY).

The Healthcare Effectiveness Data and Information Set (HEDIS®) is a registered trademark of NCQA.

Antibiotics are most often inappropriately prescribed for acute bronchitis.  This measure assesses the percentage of episodes among members ages 3 months and older with a diagnosis of acute bronchitis/bronchiolitis that did not result in an antibiotic dispensing event. The Child Core Set asks states to report the rate for the subset of members age 3 months to 17 years (shown above).

Antibiotics are not indicated in clinical guidelines for treating with acute bronchitis who do not have a comorbidity or other infection for which antibiotics may be appropriate. ,  Inappropriate antibiotic treatment of patients with acute bronchitis is of clinical concern, especially since misuse and overuse of antibiotics lead to antibiotic drug resistance.  Acute bronchitis consistently ranks among the 10 conditions that account for most ambulatory office visits to U.S. physicians; furthermore, while the vast majority of acute bronchitis cases (more than 90%) have a nonbacterial cause, antibiotics are inappropriately prescribed 65%–80% of the time.5,  

Inappropriate antibiotic use can be addressed by reminding providers of clinical guideline recommendations and providing feedback about their prescribing behaviors. In addition, use of patient education interventions can discourage seeking antibiotics for viral conditions (such as the common cold), or without confirmatory tests such as group A strep test for pharyngitis.

Last updated: 11/29/23