Key points:
- Researchers tracked antibiotic prescriptions from 2017 to 2021 to determine if the diagnosis justified antibiotic use.
- The team found that 1 in 4 antibiotic prescriptions went to patients who had conditions that antibiotics could not treat.
- The findings highlight the importance of preventing unnecessary antibiotic prescription, which may lead to antimicrobial resistance.
A new study finds that 1 in 4 antibiotic prescriptions in the United States goes to patients who have conditions that they are useless against. These findings, published in Clinical Infectious Diseases, indicate that disease-causing bacteria may evolve in a way that could make antibiotics useless for the patients who need them.
Researchers used data from more than 37.5 million children and adults covered by private insurance or Medicare Advantage plans from 2017 to 2021. These patients received antibiotic prescriptions both in-person and telehealth visits. The team examined the diagnosis given to each patient and classified the prescription as inappropriate if the diagnosis did not justify antibiotic use.
During the five years of the study, the percentage of inappropriate prescriptions rose from 25.5% to 27.1%. Researchers found that older adults with Medicare Advantage coverage had a higher likelihood of receiving inappropriate antibiotics relative to adults and children with private insurance.
The team also examined which diagnoses were associated with receiving antibiotics for inappropriate reasons. They found that “contact with and suspected exposure to COVID-19” was one of two most common reasons. In fact, of all the inappropriate antibiotics prescriptions from the last half of 2021, 15% were for a COVID-19 infection.
“Our study shows that the decline in exposure to inappropriate antibiotic prescriptions during the pandemic was only temporary,” said lead author Kao-Ping Chua of University of Michigan. “Our findings highlight the continued importance of quality improvement initiatives focused on preventing unnecessary antibiotic prescribing and antimicrobial resistance.”