Study: One-Third of Antibiotic Prescriptions May Be Inappropriate

Nearly a third of outpatient antibiotic prescriptions in the US may be inappropriate, according to the results of a recent study.

Although the National Action Plan for Combating Antibiotic-Resistant Bacteria has set a goal of reducing inappropriate outpatient antibiotic use by 50% by 2020, the actual rate of inappropriate antibiotic use is not known.
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To estimate the extent of inappropriate prescriptions, researchers analyzed data from the 2010-2011 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey on antibiotic prescriptions by age, region, and diagnosis.

Using national guidelines and regional variation in prescribing, the researchers estimated rates of total and appropriate antibiotic prescriptions.

Of the 184,032 sampled visits, 12.6% yielded antibiotic prescriptions, with sinusitis associated with the most prescriptions per 1000 population, followed by suppurative otitis media and pharyngitis.

Acute respiratory conditions led to 221 antibiotic prescriptions per 1000 population, but only 111 were estimated to be appropriate. Overall, among all conditions, an estimated 506 prescriptions per 1000 population were written in 2010-2011, but only 535 were estimated to be appropriate.

“In the United States in 2010-2011, there was an estimated annual antibiotic prescription rate per 1000 population of 506, but only an estimated 353 antibiotic prescriptions were likely appropriate, supporting the need for establishing a goal for outpatient antibiotic stewardship,” the researchers concluded.

—Michael Potts

Reference:

Fleming-Dutra KE, Hersh AL, Shapiro DJ, et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011. JAMA. 2016;315(17):1864-1873.