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While it is no secret that the overuse of antibiotics has caused an increase in antibiotic-resistant infections, a new study estimates that as many as 30 percent of all antibiotics prescribed for outpatient treatment may be inappropriate.
The large study, which was published in JAMA’s May 3rd issue, looked at antibiotic use between 2010 and 2011 and found that doctors prescribed antibiotics at a rate of 506 per 1000 population across all conditions. Researchers say the prescriptions were only appropriate in 353 cases per 1000 population.
According to pediatrician Katherine E. Fleming-Dutra, MD, who works with the Centers for Disease Control and Prevention in Atlanta, Georgia, the study emphasizes the need to improve antibiotic stewardship in the ambulatory setting.
Cutting the rate of unnecessary outpatient antibiotic use in half by the year 2020 has been an ambitious goal of the National Action Plan for Combating Antibiotic-Resistant Bacteria. However, prior to the new study, data on the actual level of antibiotic misuse was lacking. Thanks to the study, practitioners now have some solid data regarding the rates of prescribing antibiotics by age and diagnosis as well as the proportion that may be unnecessary for both adults and children in America.
For the study, researchers pulled data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey.
Of the 184,032 doctor’s visits in the data sample, 12.6% resulted in a prescription being written for antibiotics. The conditions (per 1000 population) that most frequently received a prescription for antibiotics included:
"Half of antibiotic prescriptions for acute respiratory conditions may have been unnecessary, representing 34 million antibiotic prescriptions annually," the authors wrote in the study. "Collectively, across all conditions, an estimated 30% of outpatient, oral antibiotic prescriptions may have been inappropriate. Therefore, a 15% reduction in overall antibiotic use would be necessary to meet the White House National Action Plan for Combating Antibiotic-Resistant Bacteria goal of reducing inappropriate antibiotic use in the outpatient setting by 50% by 2020."
Experts say that education will need to take place among both practitioners and patients in order to make significant progress toward decreasing antibiotic overuse.
You can read more about the full study at Medscape.