May 04, 2016
New findings published Tuesday shed more light on the rising problem of "superbugs," or antibiotic-resistant microbes, showing that at least 30 percent of antibiotics prescribed in the United States are unnecessary.
Modern Healthcaredescribes the analysis as "the first detailed look at all antibiotic prescribing throughout the country."
The U.S. Centers for Disease Control and Prevention (CDC), in collaboration with Pew Charitable Trusts and other public health and medical experts, used data from the 2010-2011 National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey, and identified "47 million excess prescriptions."
Thirty percent of the 154 million prescriptions for antibiotics given at doctors' offices and emergency departments were wrong, the study found. That's because most were prescribed for respiratory conditions caused by viruses, such as sinus and ear infections, which do not respond to antibiotics.
And those figures are likely conservative. According to the Washington Post:
An accompanying editorial in JAMA noted that the numbers provided in the report likely are an undercount because they don't include the times antibiotics are given when patients talk to doctors' offices over the telephone, or when patients seek medical care at urgent care clinics, retail pharmacies and dentists' offices.
Also not included are prescriptions written by nurse practitioners and physician assistants.
"Antibiotics are lifesaving drugs, and if we continue down the road of inappropriate use we'll lose the most powerful tool we have to fight life-threatening infections," said CDC head Tom Frieden in a press statement.
The study was published in the journal JAMA, and, using same data, Pew also published a report on its website entitled "Antibiotic Use in Outpatient Settings."
"While our estimates of unnecessary antibiotic use are conservative," stated David Hyun, M.D., a senior officer with Pew's antibiotic resistance project, "it is clear that a small number of health conditions constitute the lion's share of unwarranted antibiotic prescriptions in this country."
The study is part of the CDC's effort to help meet the White House goal, laid out in 2015, to tackle the problem of antibiotic-resistant bacteria. It set a goal of slashing inappropriate outpatient antibiotic use by half by 2020.
The CDC and the World Health Organization have previously issued warnings about the rise of antimicrobial resistance, with Dr. Keiji Fukuda, WHO's assistant director-general for health security, warning last year that "much more work needs to be done to combat one of the most serious global health threats of our time."
Food safety and environmental watchdogs have highlighted the threat as well, pointing to overuse in farm animals in industrial agriculture as contributing to the problem.
"The more antibiotics are used, the less effective they become," said Kathy Talkington, director of Pew's antibiotic resistance project. "Reducing the needless use of antibiotics will slow the emergence of antibiotic-resistant microbes, so-called superbugs, which are among the most urgent public health threats of our time."
"Patients and health care providers must work together to understand when antibiotics will help and when they won't, and help preserve these lifesaving drugs for patients who really need them," she said.
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