Health Care Providers’ Prescription Practices of Antibiotics Examined

The majority of antibiotics prescribed to adults aged 65 years or older, Black patients, and Hispanic/Latinx patients in the outpatient setting are considered inappropriate, according to results of a study presented at the 2022 European Congress of Clinical Microbiology & Infectious Diseases conference.

Researchers utilized data from the US Centers for Disease Control and Prevention National Ambulatory Medical Care Survey (NAMCS) to examine antibiotic prescription practices across the United States. Included between 2009 and 2016 were more than 5.7 billion visits for individuals aged 18 years or older, and 1.3 billion visits for pediatric patients.

Antibiotic use was defined here as at least 1 oral antibiotic prescription ordered during an outpatient visit. Antibiotic prescribing was defined here as visits that included an antibiotic per 1000 total patient visits.

The results indicated that 74% of antibiotics prescribed to patients aged 65 years or older, 64% of prescriptions for Black patients, 58% for Hispanic/Latinx patients, and 58% for men were prescribed inappropriately.

Antibiotic prescribing rates were highest among Black patients (122 prescriptions per 1000), Hispanic/Latinx patients (139 per 1000), patients younger than 18 years (114 per 1000), and women (170 per 1000). Bacterial infections such as non-bacterial skin conditions, viral respiratory tract infections, and bronchitis were the most common illnesses for which inappropriate antibiotics were prescribed.

“Our results suggest that Black and Hispanic/Latinx patients may not be properly treated and are receiving antibiotic prescriptions even when not indicated,” concluded researchers. “We know that physicians typically send patients home with antibiotics if they suspect their symptoms may lead to an infection. This practice becomes more common when patients are unlikely to return for a follow-up visit (ie, no established care within a clinic or hospital system) which more frequently happens in minority populations.”

“In older adults, inappropriate prescribing in primary care is associated with a wide range of adverse outcomes, including emergency hospital attendances and admissions, adverse drug events, and poorer quality of life. Our results underscore that strategies to reduce inappropriate prescribing must be tailored for outpatient settings,” concluded authors.

—Leigh Precopio

Reference:

Young E, et al. Poster 1758. Presented at: European Congress of Clinical Microbiology & infectious Diseases; April 23-26, 2022; Lisbon, Portugal. Accessed May 3, 2022. https://www.eccmid.org/