MPC Member Publications

This database contains a listing of population studies publications written by MPC Members. Anyone can add a publication by an MPC student, faculty, or staff member to this database; new citations will be reviewed and approved by MPC administrators.

Full Citation

Title: Racial and Ethnic Differences in the Determinants of Antibiotic Use for Acute Gastroenteritis in the United States

Citation Type: Journal Article

Publication Year: 2026

ISSN: 3067-2007

DOI: 10.64898/2026.02.04.26345585

Abstract: Background Most gastrointestinal infections do not require antimicrobial treatment, and the overall rate of use is low. However, differences in use across major American racial and ethnic groups is poorly understood. We estimated racial and ethnic disparities in antibiotic use for gastroenteritis and identified population-specific factors associated with use. Methods We analyzed the nationally representative 2018-2019 FoodNet Population Survey, limited to 1,950 individuals reporting gastroenteritis in the previous 7 days. Race and ethnicity were categorized as non-Hispanic Black, Hispanic, Other (Asian, Pacific Islander, American Indian and Alaska Native, and multiracial), and non-Hispanic White. Modified Poisson regression with survey weights estimated risk ratios for antibiotic use overall and within racial and ethnic groups. Results Antibiotic use was substantially higher among non-Hispanic Black (RR 4.6; 95% CI 4.01, 5.28), Hispanic (RR 2.2; 95% CI 1.00, 4.96), and Other (RR 3.8; 95%CI 2.27, 6.38) individuals, relative to non-Hispanic White respondents. Clinical factors were strongly associated with use in all racial and ethnic groups. However, socioeconomic associations qualitatively differed across groups; for example, higher income was associated with greater antibiotic use among Hispanic individuals but lower use among non-Hispanic Black individuals. Associations with social environment factors, such as Social Vulnerability Index and provider density, also varied by group. Conclusions We identified marked racial and ethnic disparities in antibiotic use, even after accounting for clinical and socioeconomic factors. Drivers of use differed by group, underscoring the need for tailored stewardship strategies and attention to the sociocultural factors influencing access to care and treatment decisions. Summary Antibiotic use for gastroenteritis is low; however, antibiotic use is significantly greater among individuals identifying as Black, Hispanic, or other races and ethnicities, relative to White individuals. Factors associated with use vary by population, emphasizing needed tailoring of stewardship strategies. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was funded in part by The Institute for Social Research and Data Innovation at the University of Minnesota. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Institutional Review Board of University of Minnesota waived ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data are restricted and cannot be shared by the authors. Access may be obtained from the CDC through application and a data use agreement. Analytic code (and derived, non-identifiable summary outputs) can be made available upon reasonable request to the corresponding author.

Url: https://www.medrxiv.org/content/10.64898/2026.02.04.26345585v1

Url: https://www.medrxiv.org/content/10.64898/2026.02.04.26345585v1.abstract

User Submitted?: No

Authors: Kim, Dongwook; Ismail, Raida; Roberts, Finn; Tarr, Gillian A.M.

Periodical (Full): medRxiv

Issue:

Volume:

Pages: 2026.02.04.26345585

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