7 things to know about inpatient, outpatient antibiotic use

A "significant portion" of antibiotic prescriptions written in the U.S. is inappropriate, and the nation lacks a lot of the data needed to make a dent in the fight against antibiotic resistance, according to a report from Pew issued this month.

"Enhanced data are needed across all settings in order to design targeted and effective stewardship interventions that will improve the use and preserve the effectiveness" of antibiotics, according to the report, "Trends in U.S. Antibiotic Use".

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With the limited data available, the Pew report did put together statistics and information on antibiotic use in the U.S. healthcare system.

Inpatient use

1. More than half of all hospital patients receive antibiotics.

2. Use of broad-spectrum antibiotics increased between 2006 and 2012, while the use of targeted, narrow-spectrum antibiotics decreased. "As broad-spectrum antibiotics have been shown to significantly increase the risk of drug-resistant infections, this trend is concerning."

3. One study of a sample of hospitals found 37 percent of prescriptions for urinary tract infections were potentially unnecessary or inappropriate.

Outpatient use

4. While the number of antibiotic prescriptions written in physicians' offices, emergency departments and other outpatient settings declined 6 percent from 2006 to 2014, it remained more than 2.5 times Sweden's outpatient prescription rate.

5. One in three outpatient antibiotic prescriptions are unnecessary.

6. Of the unneeded prescriptions, most are for acute respiratory infections that are not caused by bacteria, like asthma, allergies or colds.

7. For three common respiratory conditions that are treatable with antibiotics, providers chose the wrong antibiotic in a third of cases.

Getting more data

Ultimately, the Pew researchers argue more data is needed. They suggest the following capturing antibiotic prescription data from retail and urgent care clinics and dentists offices and via telemedicine; and mandating reporting of hospital antibiotic use through the National Healthcare Safety Network.

More articles on antibiotic use:
Antibiotic therapy may not alter Enterobacteriaceae bacteraemia-associated mortality in ICUs: 4 insights
FDA approves diagnostic tool for antibiotic stewardship
Treating bone infections with bioactive glass lowers antibiotic use

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