About half of US hospital patients were on an antibiotic in 2023 — essentially flat from 2015 — even as nearly all hospitals now run stewardship programs, a CDC survey found.
Among 151 hospitals that took part in both the 2015 and 2023 point-prevalence surveys, antibiotic use held steady: 49.2% of patients in 2015 and 49.1% in 2023. The findings were published July 31 in Open Forum Infectious Diseases.
Here are four things to know:
1. Across the full 2023 sample, 49.7% of 13,653 patients at 218 hospitals in 10 states received at least one antibiotic on the survey day or the day before, mostly broad-spectrum drugs. The survey ran May 1 to Sept. 30, 2023, and was conducted by CDC researchers and state health departments.
2. The flat top line masked shifts in prescribing. Fluoroquinolone use fell from 9.2% to 2.8%, while third- and fourth-generation cephalosporin use climbed from 12.3% to 18.6%. In neonatal critical care units, use dropped from 23.4% to 17.1%; in mother-baby units, it rose from 24.4% to 32.8%.
3. Stewardship infrastructure, meanwhile, is now near-universal. Antibiotic stewardship programs were in place at 98.6% of surveyed hospitals in 2023, up from 79.4% in 2015 — driven in part by a CMS rule requiring all hospitals to run these programs.
4. The study’s authors cautioned that cutting volume may be the wrong target. They wrote: “Given the increasing complexity of inpatient care, substantial reductions in overall hospital [antibiotic use] prevalence may be difficult to achieve, and lower … prevalence alone may not reflect optimized use.”
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