Overprescribing Antibiotics Still an Issue

Antibiotics are important drugs used to fight bacterial infections, but they do not work against viral infections. Most acute respiratory infections (ARIs), such as bronchitis or the common cold, are caused by viral infections, yet 1 in 10 health care providers prescribe antibiotics to treat these infections. In a recent study published inAnnals of Internal Medicine,researchers looked at the national trends in antibiotic prescriptions written for ARIs in an outpatient setting at a Veteran’s Affairs health clinic settings over an 8-year period. The study found that 68.4% of patients with an ARI received an antibiotic prescription. The highest prescribing antibiotic prevalence indication was bronchitis (85%), which does not require antibiotic use in the majority of cases.

On average, clinicians prescribe an antibiotic for ARI’s almost 70% of the time for ARI’s, while a small percentage prescribe an antibiotic almost 95% of the time, and another percentage only 40% of the time. These statistics indicate that the prescribing of antibiotics is dependent on the provider. According to ARI guidelines, it is rarely necessary to prescribe an antibiotic to treat the infection, and therefore providers may be setting their own standards to decide when to write antibiotic prescriptions.

This upward trend of overwriting antibiotic prescriptions is becoming an important public health concern due to issues with antibiotic resistance. In September 2014, President Barack Obama signed an Executive Order as part of the 5-year National Action Plan for Combating Antibiotic-Resistance Bacteria in order to promote the “detecting, preventing and controlling antibiotic-resistant microbes.”

Antibiotic resistance is a very serious problem, forcing some providers to prescribe the rare, last-line antibiotics that should only be reserved for serious bacterial infections for simple infections. This can also cause patients to become more susceptible to super infections that are hard to treat due to this resistance. With the advent of the season of viral infections, such as cold and flu, it is important that providers spend the time to correctly diagnose patients’ infections and only write prescriptions for antibiotics when absolutely necessary.

Advanced practice clinicians in the retail setting should keep the issue of overprescribing antibiotics in the forefront of their mind. Clinicians should pay close attention to antibiotic prescribing guidelines to ensure they are writing prescriptions for antibiotics only when necessary.

The study was published in the July 21, 2015, issue of theAnnals of Internal Medicine.