An analysis of outpatient antibiotic prescribing in the United States from 2017 through 2021 was recently published in Clinical Infectious Diseases. The study shows that rates of inappropriate prescribing returned to baseline levels following a brief drop at the beginning of the COVID-19 pandemic.
The analysis included over 37.5 million enrollees from national commercial and Medicare Advantage claims databases. Antibiotic prescriptions for children and adults were analyzed monthly. An antibiotic appropriateness scheme determined whether diagnostic codes justified antibiotic prescribing. Among the 60.6 million antibiotics dispensed during the study period, 15.6% were appropriate, 29.4% were potentially appropriate, 25% were inappropriate, and 30% were not associated with a recent diagnostic code.
In December 2019, 1.7% of total enrollees had inappropriate prescriptions. In April 2020, this decreased to 0.9%, and by December 2021, it returned to 1.7%. Notably, from March 2020 to December 2021, one of the two most common diagnoses among people who received inappropriate antibiotics was “contact with and suspected exposure to COVID-19.” The decline in inappropriate prescribing in March 2020 was likely due to fewer provider visits during the pandemic. The subsequent increase was partly because overall antibiotic dispensing rebounded and partly due to a higher proportion of inappropriate prescriptions.
”This study reinforces the importance of promoting responsible prescribing practices to combat antimicrobial resistance and prevent thousands of unnecessary deaths. Quality improvement initiatives focused on preventing unnecessary antibiotic prescribing and antimicrobial resistance are a patient safety priority,” shared Carrie Sorenson, PharmD; Quality Improvement Advisor with Great Plains QIN.
Telemedicine Grant Opportunity
Clinics and providers that want to improve antibiotic prescribing and learn how to improve patient safety and reduce harm associated with antibiotics can participate in a free 18-month AHRQ program that starts in June 2024. Access our blog post for eligibility details, expectations and value of participating.
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Urban to Rural Partners: Working Together on Antimicrobial Stewardship (UTIs in LTCFs)
May 16, 2024 | 12:00 – 1:00 pm (CT)
Additional Tools, Resources, Training
References:
- US study shows post-COVID rebound in inappropriate antibiotic prescribing | CIDRAP (umn.edu)
- Changes in the Appropriateness of US Outpatient Antibiotic Prescribing After the Coronavirus Disease 2019 Outbreak: An Interrupted Time Series Analysis of 2016–2021 Data | Clinical Infectious Diseases | Oxford Academic (oup.com)
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Antibiotic Awareness: What are antibiotics, why is antibiotic awareness important and how can we be good stewards when using antibiotics? Knowing when antibiotics are needed and how antibiotic misuse can affect others is key to having antibiotics work when we need them. Take a few minutes to listen and learn more.