Beware Unnecessary Antibiotics from Urgent Care Centers

Have you ever visited an urgent care center or a retail clinic (like those found in some pharmacies)? It can be a convenient way to get medical attention when your regular doctor won’t have an appointment for weeks. What’s more, urgent care usually results in less time and drama (not to mention a lower bill) than going to the ER.  Most people don’t want to wait five to ten hours in an emergency department at their local hospital, especially if they are not certain it is really an emergency. An urgent care center or a retail clinic provides an alternative. One big problem with that decision: unnecessary antibiotics.

Urgent Care and Unnecessary Antibiotics:

Below, we describe a study from seven years ago that found patients visiting urgent care centers might be offered unnecessary antibiotics. We wish we could report that the problem has been solved, or at least that it is better. Unfortunately, the most recent research suggests that this is a persistent problem.

Investigators from Michigan and Illinois reviewed records from more than 22 million visits to urgent care centers between 2018 and 2022 (Annals of Internal Medicine, July 21, 2025). They were looking at urgent care centers specifically because previous studies (like the one described below) had revealed prescriptions for unnecessary antibiotics for viral respiratory infections. Antibiotics do nothing to speed recovery from viral infections.

Not Just Antibiotics:

These researchers found that antibiotics were not the only drugs being prescribed inappropriately for urgent care patients. Nearly 11 million patients were seen, and 12 percent of the time, they got prescriptions for antibiotics. In addition, 9 percent of the visits resulted in prescriptions for a glucocorticoid such as prednisone, and 1 percent led to prescriptions for an opioid pain reliever. Now, some of these prescriptions were completely appropriate. For example, the scientists judged that antibiotics were appropriate for 58 percent of the respiratory tract infections seen and 64 percent of the urinary tract infections. But that still leaves a lot of unnecessary antibiotics being prescribed.

Glucocorticoids (aka corticosteroids or cortisone-like drugs) were prescribed inappropriately 40 percent of the time for acute bronchitis and 12 percent of the upper respiratory infections. Doctors are a bit more cautious about prescribing opioids, but even so, nearly 5 percent of the urgent care patients with muscle and joint pain got an inappropriate prescription for an opioid. So did 4 percent of the folks with sprains and strains.

The authors conclude:

“In conclusion, urgent cares continue to demonstrate inappropriate antibiotic, glucocorticoid, and opioid prescribing, reinforcing the need for multifaceted programs to reduce inappropriate prescribing and potential harm. Future studies should focus on identifying components for urgent care–tailored stewardship programs.”

We are somewhat discouraged to read that inappropriate use of antibiotics is still a problem at urgent care centers. Infectious disease experts and public health authorities have been striving to reduce this problem, urging their colleagues to exercise more responsible stewardship. Here’s why they are concerned.

Why Unnecessary Antibiotics Are a Problem:

Antibiotic misuse is associated with bacterial resistance and diminishing value of the antibiotics. It may also lead to infections such as Clostridium difficile, which causes severe diarrhea. There are also side effects associated with some antibiotics, as we wrote about in this post.

What The Researchers Discovered:

The earlier study we mentioned found that a lot of patients got unnecessary antibiotics in urgent care centers (JAMA Internal Medicine , July 16, 2018). The investigators reviewed insurance claims from 2014. This captured data on people under 65 with employer-sponsored insurance. What they found was rather shocking: Almost 40 percent of the 2.7 million urgent care center visits resulted in a prescription for an antibiotic. Approximately 16 percent of the visits to urgent care centers were for problems that shouldn’t be treated with antibiotics, such as colds. Retail clinics were no better.

In fact, 45 percent of the people at urgent care centers who were diagnosed with a problem that doesn’t respond to antibiotics got a prescription for one anyway. That compares to 25 percent of such visits in emergency departments and 17 percent in medical offices.

The authors conclude:

“The finding of the present study that antibiotic prescribing for antibiotic-inappropriate respiratory diagnoses was highest in urgent care centers suggests that unnecessary antibiotic prescribing nationally in all outpatient settings may be higher than the estimated 30%.”

“Antibiotic stewardship interventions could help reduce unnecessary antibiotic prescriptions in all ambulatory settings, and efforts targeting urgent care centers are urgently needed.”

A Personal Story About Unnecessary Antibiotics:

Over a decade ago I caught a nasty upper respiratory tract infection. It left me with a lingering cough that would not quit. The cough was especially bad at night.

I realized on a Friday afternoon that we had a big fund-raiser radio show coming up the next morning. I knew that talking on the radio would be a challenge. That afternoon I decided to head to an urgent care center. BIG MISTAKE!

1. there was a surprisingly long wait.
2. the clinician insisted that I needed a chest X-ray. The X-ray technician couldn’t seem to get the image right and took a whole bunch of unnecessary X-rays.
3. the clinician determined that the X-rays did not show I had pneumonia. She prescribed an antibiotic anyway, which I was pretty sure would be useless. Unnecessary antibiotics at an urgent center, just like the new research estabished.
4. the clinician administered a bronchodilator using an aerosol inhalator device. It didn’t help much, if at all.
5. I got a call the following Monday that a radiologist had double-checked my chest X-rays and saw a spot on my lungs that worried him. I was told to come in for more X-rays. Needless to say, that totally freaked me out!
6. I went to the radiology clinic and got more chest X-rays, scans and continuous radiation than I would ever want in a lifetime. At the end of the process the radiologist said he couldn’t tell what the spot was and I should come back in six months and repeat the entire process to see if the spot had grown.

Instead I opted for a CT scan at another radiology center. The radiologist there said it was a calcium deposit on a rib and nothing to worry about. Of course the CT scan meant a LOT more ionizing radiation.

My Perspective on Unnecessary Antibiotics:

My visit to the urgent care center resulted in a prescription for unnecessary antibiotics. The medicine wouldn’t have done anything for my cough. As a bonus, I got a lung-cancer scare and way more ionizing radiation than I needed. All this to determine that my “spot” was nothing to worry about.

I am sure that there are great urgent care centers and doctors who do not prescribe unnecessary antibiotics. But judging from the latest research, far too many are.

Share your own story about unnecessary antibiotics in the comment section below.