A study published online February 26, 2018 in JAMA Internal Medicine has shown high frequency of systemic corticosteroid use for acute respiratory tract illnesses in ambulatory settings. This is despite clinical practice guidelines not recommending systemic steroids in the treatment of acute respiratory tract infections. A medical history of chronic obstructive pulmonary disease (COPD) or asthma, a visit diagnosis of bronchitis, and an encounter with a nurse practitioner or physician assistant were found to be factors likely to increase chances of steroids being prescribed.