Broad-Spectrum Antibiotic Rxs High in Ambulatory Care Settings
(HealthDay News) – Most ambulatory care antibiotic prescriptions are for broad-spectrum agents, which are commonly prescribed for conditions for which antibiotics are rarely indicated, according to research published online July 25 in the Journal of Antimicrobial Chemotherapy.
Daniel J. Shapiro, from University of Utah in Salt Lake City, and colleagues used data from the National Ambulatory and National Hospital Ambulatory Medical Care Surveys (2007–2009) to identify patients ≥18 years seen in U.S. physician offices, hospital outpatient departments, and emergency departments. By diagnoses, types of antibiotics prescribed were determined, including use of broad- versus narrow-spectrum drugs.
The researchers found that, in 101 million annual ambulatory visits, antibiotics were prescribed at 10% of all visits. In the majority of visits (61%), broad-spectrum agents were prescribed. Quinolones (25%), macrolides (20%), and aminopenicillins (12%) were the most commonly prescribed. The conditions for which antibiotics were most commonly prescribed were: respiratory conditions (41%), skin/mucosal conditions (18%), and urinary tract infections (9%). Among patients prescribed antibiotics, broad-spectrum agents were more likely to be prescribed for respiratory infections (for which antibiotics are rarely indicated), during visits to emergency departments, and for patients ≥60 years.
"Antibiotic stewardship interventions targeting respiratory and non-respiratory conditions are needed in ambulatory care," the authors write.