St. Louis, MO—Current efforts to change clinicians’ prescribing practices and reduce the outpatient prescription of antibiotics simply might not be enough.
That’s according to a new study published in Infection Control & Hospital Epidemiology. Washington University–led researchers suggest that the national spotlight on inappropriate use of antibiotics isn’t having the desired effect and that the drugs continue to be prescribed at disturbingly high rates.
“We need to better equip prescribers with the tools and knowledge to know when antibiotics are needed. It is one of the most important steps towards reducing antibiotic resistant bacteria, as well as adverse events associated with these powerful drugs,” pointed out lead author Michael Durkin, MD, MPH, Assistant Professor of Medicine at Washington University School of Medicine. “There has been progress in reducing antibiotic prescriptions in hospitals, but there needs to be more research and attention on how to address this issue in the outpatient setting.”
For the retrospective analysis of outpatient antibiotic prescriptions, the study team used administrative claims data between January 1, 2013, and December 31, 2015, from Express Scripts Holding Company’s database of insured members. Monthly prescription rates for all antibiotics, as well as the five most commonly prescribed antibiotics—azithromycin, amoxicillin, amoxicillin/clavulanate, ciprofloxacin, and cephalexin—were tracked.
No change was identified in the overall annual antibiotic prescribing rate, or the prescribing rate of any specific drug. Researchers note, however, that time of year seemed to matter: Overall, seasonal prescribing peaked in February and was 42% higher than the lowest rate in September.
While inappropriate treatment for viral conditions—which tend to occur more frequently in the winter—has been cited as a problem, study authors suggested that the use of antibiotics might have been justified in many of the instances they identified.
Azithromycin, amoxicillin, and amoxicillin/clavulanate, the three most common drugs reviewed, were most often prescribed in February, when pneumonia is more common.
Conversely, ciprofloxacin and cephalexin were most often prescribed in the summer months, when urinary tract infections and skin and soft-tissue infections tend to occur.
“If quality improvement guidelines were sufficient to improve antibiotic prescribing practices, then we would have expected to see an overall decrease in antibiotic prescribing rates over time. However, standalone educational materials are rarely successful for changing clinician behavior,” Durkin emphasized. “A more rigorous framework and greater investment of resources is needed to substantially improve outpatient antibiotic prescribing rates, helping to combat antibiotic resistance and improve patient safety.”
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That’s according to a new study published in Infection Control & Hospital Epidemiology. Washington University–led researchers suggest that the national spotlight on inappropriate use of antibiotics isn’t having the desired effect and that the drugs continue to be prescribed at disturbingly high rates.
“We need to better equip prescribers with the tools and knowledge to know when antibiotics are needed. It is one of the most important steps towards reducing antibiotic resistant bacteria, as well as adverse events associated with these powerful drugs,” pointed out lead author Michael Durkin, MD, MPH, Assistant Professor of Medicine at Washington University School of Medicine. “There has been progress in reducing antibiotic prescriptions in hospitals, but there needs to be more research and attention on how to address this issue in the outpatient setting.”
For the retrospective analysis of outpatient antibiotic prescriptions, the study team used administrative claims data between January 1, 2013, and December 31, 2015, from Express Scripts Holding Company’s database of insured members. Monthly prescription rates for all antibiotics, as well as the five most commonly prescribed antibiotics—azithromycin, amoxicillin, amoxicillin/clavulanate, ciprofloxacin, and cephalexin—were tracked.
No change was identified in the overall annual antibiotic prescribing rate, or the prescribing rate of any specific drug. Researchers note, however, that time of year seemed to matter: Overall, seasonal prescribing peaked in February and was 42% higher than the lowest rate in September.
While inappropriate treatment for viral conditions—which tend to occur more frequently in the winter—has been cited as a problem, study authors suggested that the use of antibiotics might have been justified in many of the instances they identified.
Azithromycin, amoxicillin, and amoxicillin/clavulanate, the three most common drugs reviewed, were most often prescribed in February, when pneumonia is more common.
Conversely, ciprofloxacin and cephalexin were most often prescribed in the summer months, when urinary tract infections and skin and soft-tissue infections tend to occur.
“If quality improvement guidelines were sufficient to improve antibiotic prescribing practices, then we would have expected to see an overall decrease in antibiotic prescribing rates over time. However, standalone educational materials are rarely successful for changing clinician behavior,” Durkin emphasized. “A more rigorous framework and greater investment of resources is needed to substantially improve outpatient antibiotic prescribing rates, helping to combat antibiotic resistance and improve patient safety.”
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