Antibiotic prescribing practices in a teaching clinic: comparison of resident and staff physicians.

BACKGROUND: The widespread and often inappropriate use of broad spectrum antibiotics in the outpatient setting is recognized as a significant contributing factor to the spread of bacterial resistance. We hypothesized that residents prescribe broader spectrum antibiotics more frequently than staff physicians and adopt more appropriate prescribing practices with increasing levels of training. METHODS: All patient visits for acute sinusitis in our teaching practice between July 1, 1995, and June 30, 1997, were reviewed. Comparisons of antibiotics prescribed were made between staff and residents at each level of training. RESULTS: First- and second-year residents were more likely to prescribe narrow spectrum antibiotics (56%) than third-year residents (35%) or staff (34%). CONCLUSIONS: Junior residents in our program are more likely to prescribe narrow spectrum antibiotics for the treatment of acute sinusitis than are senior residents or staff. With advancement in level of training, prescribing practices of residents come to resemble those of their supervising staff physicians.