Researchers analyzed 2004-13 Medicaid claims data of 298 million antibiotic fills — 62 percent of which were for children — for 53 million patients. The study found 55 percent of antibiotic fills were for clinician visits with an infection-related diagnosis, 17 percent were for clinician visits without an infection-related diagnosis and 28 percent were prescribed without an in-person visit.
About half of the prescriptions occurring without a clinic visit were associated with laboratory testing or home care services. Children were less likely than adults to be prescribed antibiotics without a clinic visit.
The findings could mean antibiotic stewardship efforts aimed at reducing inappropriate prescribing miss a large percentage of prescriptions.
“We’re not saying that every one of these antibiotic prescriptions is clinically inappropriate or problematic … but we are saying that we all need to look carefully at what’s going on,” Michael Fischer, MD, study author and associate professor of medicine at Boston-based Harvard Medical School, told Medscape. “We need to figure out whether this could be contributing to overuse and the problems that result from overuse.”
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