Study: Antibiotics still overprescribed in outpatient settings, despite efforts to improve prescribing practices

Annual outpatient antibiotic prescription rates remained virtually unchanged from 2013 through 2015, despite national efforts to curb unnecessary prescriptions due to the mounting issue of antibiotic resistance, according to a study published in the journal Infection Control & Hospital Epidemiology.

For the study, researchers examined administrative claims information compiled between 2013-15 in Express Scripts Holding Co.'s member database. Researchers found members filled 98 million antibiotic prescriptions over the three-year period. The average number of prescriptions per 1,000 members ranged from 830 to 849 annually. Researchers identified a decrease in prescription rates between 2013 and 2014, followed by an increase in 2015. The team identified the top five most-prescribed antibiotics as azithromycin, amoxicillin, amoxicillin/clavulanate, ciprofloxacin and cephalexin.

"If quality improvement guidelines were sufficient to improve antibiotic prescribing practices, then we would have expected to see an overall decrease in antibiotic prescribing rates over time," said lead study author Michael Durkin, MD, assistant professor of medicine at Washington University School of Medicine in St. Louis. "A more rigorous framework and greater investment of resources is needed to substantially improve outpatient antibiotic prescribing rates, helping to combat antibiotic resistance and improve patient safety."

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