Study: ERs show no improvement in inappropriate antibiotic use for adults

Although there is a decline in inappropriate use of antibiotics to treat acute respiratory tract infections (ARTIs) in many outpatient settings, the number of adults still receiving those antibiotics in emergency departments, is high, according to a study abstract published by the American Society for Microbiology.

Researchers analyzed data from 2001-2010 from the National Hospital Ambulatory Medical Care Survey, identifying patients with ARTIs and rates of antibiotic use, classified as either antibiotic-appropriate or antibiotic-inappropriate, according to the abstract.

There were 126 million emergency department ARTI diagnoses, with 61 percent warranting antibiotics. Over the course of the study, antibiotic-inappropriate use decreased in children less than 5 years old and young people ranging from 5-19 years old, but remained stable for adult patients in the 20 years-old to 64-years-old age range. In fact, quinolone use for ARTI increased from 83 per 1,000 to 105 per 1,000 visits over the life of the study, researchers said.

"While emergency department antibiotic use for acute respiratory tract infections decreased in the past decade among children, we saw no decrease in antibiotic use for adults with acute respiratory tract infections," said coauthor John Baddley, M.D., of the University of Alabama at Birmingham in a statement. "Given organized efforts to emphasize antibiotic stewardship, we expected to see a decrease in emergency department antibiotic use for such infections."

ARTIs, including rhinitis, sinusitis and bronchitis, account for nearly one tenth of ambulatory care visits across the country, according to the statement, but are caused by viruses, not bacteria, and when treated with antibiotics can lead to antibiotic resistance.  

Refraining from unnecessary antibiotics isn't just good for patients. It can help reduce hospitals' expenses. The University of Maryland Medical Center in Baltimore shaved $3 million from its annual budget by monitoring the unnecessary use of antibiotics for three years, FierceHealthcare previously reported.

To learn more:
- here's the study abstract
- read the statement