America is going the wrong way when it comes to prescribing antibiotics, with 1 in 4 prescriptions going to patients who have conditions that the drugs won’t touch, a new study finds.
In fact, the percentage of all antibiotic prescriptions given to treat conditions they’re useless against was even higher in December 2021 than it was before the pandemic began, the study shows.
And that means more chances for disease-causing bacteria to evolve in ways that could make antibiotics useless for the patients who truly need them.
The percentage of people getting antibiotics for inappropriate reasons actually decreased a bit in the early months of the pandemic, when far fewer people sought medical care for infectious or non-infectious reasons, the new research shows. But it got back on the wrong track soon after.
The study, published in the journal Clinical Infectious Diseases by a team from the University of Michigan, Northwestern University and Boston Medical Center, is based on data from more than 37.5 million children and adults covered by private insurance or Medicare Advantage plans from 2017 to 2021. Patients received antibiotic prescriptions from both in-person and telehealth visits.
The team looked back at any new diagnosis given to each patient on the day they received a prescribed antibiotic, or in the three days prior to getting the prescription. If none of these diagnoses justified the use of antibiotics, they classified the prescription as inappropriate.
“Our study shows that the decline in exposure to inappropriate antibiotic prescriptions during the pandemic was only temporary,” says lead author Kao-Ping Chua, M.D., Ph.D., a pediatrician and health care researcher in the Department of Pediatrics at the U-M Medical School. “Our findings highlight the continued importance of quality improvement initiatives focused on preventing unnecessary antibiotic prescribing and antimicrobial resistance, which kills 48,000 Americans per year.”
Chua is a member of the Susan B. Meister Child Health Evaluation and Research center, and the U-M Institute for Healthcare Policy and Innovation , and has a joint appointment in the U-M School of Public Health.
Key findings:
In addition to Chua, the study’s authors are Michael Fischer, MD, MS of the Boston Medical Center, statistician Moshiur Rahman, PhD of CHEAR, and Jeffrey Linder, MD, MPH of Northwestern University.
The study did not involve external funding.
Citation: Changes in the Appropriateness of U.S. Outpatient Antibiotic Prescribing after the COVID-19 Outbreak: An Interrupted Time Series Analysis of 2016-2021 Data, Clinical Infectious Diseases. DOI: 10.1093/cid/ciae135
Clinical Infectious Diseases
Data/statistical analysis
People
Citation: Changes in the Appropriateness of U.S. Outpatient Antibiotic Prescribing after the COVID-19 Outbreak: An Interrupted Time Series Analysis of 2016-2021 Data
22-Apr-2024