Study: Widespread Antibiotic Overprescribing by Outpatient Clinics

A new study reveals that outpatient clinics are prescribing antibiotics at an unwarranted rate, according to a news release from the Infectious Diseases Society of America. 

The research, which was presented at IDWeek 2018 and funded by the Agency for Healthcare Research and Quality, examined more than half a million prescriptions given to nearly 280,000 patients by more than 500 outpatient clinics from November 2015 through October 2017.

Key takeaways from the study are as follows:

  • 46% of antibiotics were prescribed without an infection-related diagnosis.

  • 20% of prescriptions were provided without an in-person visit.

  • For those antibiotics prescribed outside of an in-person visit, most were by phone, with others completed through electronic health record system.

  • 29% of prescriptions noted something other than an infection diagnosis (e.g., high blood pressure, annual visit).

  • 17% percent of prescriptions were written without a diagnosis indicated.

  • For those prescriptions without a diagnosis, researchers speculated that while some may be tied to poor diagnosis coding, much of it likely reflects prescribing for vague or inappropriate reasons (e.g., infections caused by viruses).

In the release, Jeffrey Linder, MD, MPH, lead author of the study, said, "We looked at all outpatient antibiotic prescribing and results suggest misuse of these drugs is a huge problem, no matter the symptom. We found that nearly half the time, clinicians have either a bad reason for prescribing antibiotics, or don't provide a reason at all. When you consider about 80% of antibiotics are prescribed on an outpatient basis, that's a concern."

The results of this study echo those of many others pointing to antibiotic misuse as a significant issue. Prescribing the correct dose of the correct antibiotic at the appropriate time and for the correct duration can help fight antibiotic resistance, protect patients from unnecessary side effects and help ensure antibiotics will work when they are needed. 

If your organization requires expert assistance with developing and maintaining an antimicrobial stewardship program, contact Infection Control Consulting Services (ICCS). ICCS is a national consulting firm providing services to healthcare facilities including outpatient clinics, ambulatory surgery centers, hospitals and nursing homes.