Tennessee review: 2% of providers account for 25% of pediatric antibiotic prescriptions

January 15, 2020

NEW YORK (January 15, 2020) -- Fewer than 2 percent of providers accounted for 25 percent of antibiotic prescriptions for children in Tennessee, with the highest number of prescriptions coming from general pediatricians and those who graduated prior to 2000, according to a study published today in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.

"Tennessee is one of the highest antibiotic prescribing states in the country, and this research is a first step to identifying patient and provider characteristics that can be used to design stewardship interventions to improve antibiotic prescribing in our state," said Sophie Katz, MD, MPH, associate director of pediatric antimicrobial stewardship, Monroe Carell Jr. Children's Hospital at Vanderbilt.

Tennessee was ranked as the sixth highest state in outpatient antibiotic prescribing in 2016. Overprescribing of antibiotics, particularly the use of broad-spectrum antibiotics instead of more targeted treatments, can lead to antibiotic resistance, though researchers in this study did not look at whether the antibiotic prescriptions were considered necessary.

Researchers reviewed data from a statewide database looking at prescriptions for patients under the age of 20 who received an antibiotic from an outpatient pharmacy in Tennessee in 2016.

The study found an average of 1,165 antibiotic prescriptions were written in 2016 for every 1,000 children and a quarter of those were for broad-spectrum antibiotics. The most commonly prescribed antibiotic was amoxicillin, accounting for more than a third of the prescriptions, followed by azithromycin at 15 percent, cefdinir at 13 percent and amoxicillin-clavulanate, 11 percent.

The prescribing rate was highest for the youngest children, with 1,575 prescriptions for every 1,000 children under 2 years old. Just 360 of 21,762 providers in the study were responsible for nearly a quarter of the broad-spectrum antibiotic prescriptions, and most of those prescribers were general pediatricians.

The study could not identify whether prescriptions were necessary, and researchers could not determine why older physicians were more likely to be high prescribers. Katz said possible reasons could be that older physicians have more patients than those who graduated more recently, they have more time constraints, or they received less education on antibiotic stewardship during their training.

The research could be helpful to other high-prescribing states such as Arkansas, Louisiana, Mississippi, Alabama, Kentucky, and West Virginia, and paves the way for qualitative studies to assess attitudes about antibiotic prescribing to identify the best interventions to reduce unnecessary antibiotic use.
Sophie E. Katz, Milner Staub, Youssoufou Ouedraogo, Christopher D. Evans, Marion A. Kainer, Marie R. Griffin, Ritu Banerjee. "Population-based Assessment of Patient and Provider Characteristics Influencing Pediatric Outpatient Antibiotic Use in a High Antibiotic Prescribing State." Infection Control & Hospital Epidemiology. Web (January 15, 2020).

About ICHE

Published through a partnership between the Society for Healthcare Epidemiology of America and Cambridge University Press, Infection Control & Hospital Epidemiology provides original, peer reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. ICHE is ranked 41st out of 89 Infectious Diseases Journals in the latest Web of Knowledge Journal Citation Reports from Thomson Reuters.

The Society for Healthcare Epidemiology of America (SHEA) is a professional society representing more than 2,000 physicians and other healthcare professionals around the world who possess expertise and passion for healthcare epidemiology, infection prevention, and antimicrobial stewardship. The society's work improves public health by establishing infection-prevention measures and supporting antibiotic stewardship among healthcare providers, hospitals, and health systems. This is accomplished by leading research studies, translating research into clinical practice, developing evidence-based policies, optimizing antibiotic stewardship, and advancing the field of healthcare epidemiology. SHEA and its members strive to improve patient outcomes and create a safer, healthier future for all. Visit SHEA online at http://www.shea-online.org, http://www.facebook.com/SHEApreventingHAIs and @SHEA_Epi.

About Cambridge University Press

Cambridge University Press is part of the University of Cambridge. It furthers the University's mission by disseminating knowledge in the pursuit of education, learning and research at the highest international levels of excellence. Its extensive peer-reviewed publishing lists comprise 45,000 titles covering academic research, professional development, over 400 research journals, school-level education, English language teaching and bible publishing. Playing a leading role in today's international marketplace, Cambridge University Press has over 50 offices around the globe, and it distributes its products to nearly every country in the world. For further information about Cambridge University Press, visit Cambridge.org.

Society for Healthcare Epidemiology of America

Related Antibiotics Articles from Brightsurf:

Insights in the search for new antibiotics
A collaborative research team from the University of Oklahoma, the Memorial Sloan Kettering Cancer Center and Merck & Co. published an opinion article in the journal, Nature Chemical Biology, that addresses the gap in the discovery of new antibiotics.

New tricks for old antibiotics
The study published in the journal Immunity reveals that tetracyclines (broad spectre antibiotics), by partially inhibiting cell mitochondria activity, induce a compensatory response on the organism that decreases tissue damage caused during infection.

Benefits, risks seen with antibiotics-first for appendicitis
Antibiotics are a good choice for some patients with appendicitis but not all, according to study results published today in the New England Journal of Medicine.

How antibiotics interact
Understanding bottleneck effects in the translation of bacterial proteins can lead to a more effective combination of antibiotics / study in 'Nature Communications'

Are antivitamins the new antibiotics?
Antibiotics are among the most important discoveries of modern medicine and have saved millions of lives since the discovery of penicillin almost 100 years ago.

Hygiene reduces the need for antibiotics by up to 30%
A new paper published in the American Journal of Infection Control (AJIC), finds improved everyday hygiene practices, such as hand-washing, reduces the risk of common infections by up to 50%, reducing the need for antibiotics, by up to 30%.

Antibiotics: City dwellers and children take the most
City dwellers take more antibiotics than people in rural areas; children and the elderly use them more often than middle-aged people; the use of antibiotics decreases as education increases, but only in rich countries: These are three of the more striking trends identified by researchers of the NRW Forschungskolleg ''One Health and Urban Transformation'' at the University of Bonn.

Metals could be the link to new antibiotics
Compounds containing metals could hold the key to the next generation of antibiotics to combat the growing threat of global antibiotic resistance.

Antibiotics from the sea
The team led by Prof. Christian Jogler of Friedrich Schiller University, Jena, has succeeded in cultivating several dozen marine bacteria in the laboratory -- bacteria that had previously been paid little attention.

Antibiotics not necessary for most toothaches, according to new ADA guideline
The American Dental Association (ADA) announced today a new guideline indicating that in most cases, antibiotics are not recommended for toothaches.

Read More: Antibiotics News and Antibiotics Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.