Despite more than 50 years of advocacy for more responsible antibiotic prescribing practices, a study published in the Journal of the American Medicine Association estimates that 30 percent of outpatient oral antibiotic scripts in the U.S. in 2010-2011 may have been inappropriate.
The rise of superbugs--bacterial infections resistant to common antibiotics--have driven increased urgency around quantifying the number of unnecessary prescriptions, according to a study announcement. Despite this rising need, efforts to curb inappropriate antibiotic use have run into stiff headwinds.
In their analysis of the study sample, the authors estimated that "a 15-percent 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 percent by 2020." Acute respiratory conditions may represent low-hanging fruit here, as the study found that half of the antibiotic prescriptions ordered in these cases may have been unnecessary.
In an accompanying commentary, Pranita D. Tamma, M.D., and Sara E. Cosgrove, M.D., of the Johns Hopkins University School of Medicine, Baltimore, characterize the estimated numbers as "likely conservative," suggesting they offer a foundation for ongoing efforts to improve prescribing practices over the coming five years. They suggest targeting the issue via a two-pronged strategy:
- Modify physicians' prescribing patterns by addressing diagnostic uncertainty and changing peer behavior
- Provide better patient education about the role of antibiotics, in order to drive more effective shared decision-making, and to relieve physicians of the potential for alienating patients who demand inappropriate treatments