Some 24 million, or 18%, of the 130.5 million prescriptions for antibiotics that ambulatory care providers wrote in 2015 in the United States had no documented reason for using the drug, according to a recent analysis.
Ambulatory care is a general term for medical care that people who are not staying in a hospital or an institution receive.
It includes, for example, visits to primary care providers — such as doctors’ offices and health centers — as well as visits to gynecologists, dermatologists, urologists, and other specialists.
The new BMJTrusted Source study also identified another 32 million ambulatory care antibiotic prescriptions as inappropriate. This figure represented 25% of the prescriptions in the dataset.
Combining the figures suggests that up to 43% of such prescriptions in the U.S. are potentially inappropriate, according to the study’s authors.
Such a high level of potentially inappropriate antibiotic prescribing makes it hard to monitor and control the use of these drugs, note the researchers.
The need for strong stewardship is a key strategy in addressing the major public health problem of antibiotic resistance.
“Antibiotic prescribing without making note of the indication in a patient’s medical records might be leading to a significant underestimation of the scope of unnecessary prescribing,” says first and corresponding study author Michael J. Ray, a researcher at Oregon State University (OSU) College of Pharmacy, in Corvallis.
“When there’s no indication documented,” he adds, “it’s reasonable to think that at least some of the time, the prescription was written without an appropriate indication present.”
Ray worked on the study with colleagues from OSU and other research centers in Oregon.
Need to strengthen stewardship
Antibiotic or antimicrobial resistance is the ability of bacteria, fungi, and other germs to survive the drugs that are supposed to kill them. It has become a threat to public health because an increasing number of germs are acquiring this ability.
The discovery of antibiotics was a turning point in human and animal health. Infections that used to maim and kill became treatable. However, a new era has begun, and many people around the world are once again becoming ill and dying from microbial infections.
According to a recent report from the Centers for Disease Control and Prevention (CDC), more than 2.8 million infectionsTrusted Source every year in the U.S. are antibiotic resistant. In addition, these infections kill more than 35,000 people a year.
The CDC argue that, while dedicated action has helped bring down these figures, the numbers of infections and deaths are still far too high.
One area of concern is the surge of resistant infections in the community. Rising community-based infection increases the number of people at risk and makes it harder to track and contain the spread. The CDC call for “stronger focus and interventions” in this area.
