Between 2010–2011, only about 353 out of 506 antibiotic prescriptions per 1000 population were deemed appropriate, a study published in JAMA reported. 

By 2020, the National Action Plan for Combating Antibiotic-Resistant Bacteria proposed a 50% reduction in inappropriate outpatient antibiotic use. However, the extent of inappropriate use is currently known. Katherine E. Fleming-Dutra, MD, from the Centers for Disease Control and Prevention (CDC), Atlanta, GA, and colleagues aimed to estimate the rates of outpatient oral antibiotic prescribing stratified by age and diagnosis, as well as by the estimated portions of antibiotic use that may be inappropriate in children and adults in the U.S.

The study authors analyzed data from the 2010–2011 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey to estimate the rates based on the number of ambulatory care visits. They determined the diagnosis-specific prevalence and rates of total and appropriate antibiotic prescriptions using national guidelines and regional prescribing variations, and estimated the appropriate annual rate of antibiotic prescriptions per 1,000 population. 

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Of the total 184,032 sampled visits, 12.6% (95% CI: 12–13.3%) led to antibiotic prescriptions. The diagnosis associated with the most antibiotic prescriptions per 1,000 population was sinusitis (56 prescriptions, 95% CI: 48–64). This was followed by suppurative otitis media (47 prescriptions, 95% CI: 41–54) and pharyngitis (43 prescriptions, 95% CI: 38–49). Overall, acute respiratory conditions led to 221 antibiotic prescriptions per 1,000 population (95% CI: 198–245) annually, but only 111 prescriptions were estimated to be appropriate for these conditions. 

For all conditions and ages combined in 2010–2011, an estimated 506 prescriptions per 1,000 population (95% CI: 458–554) were prescribed annually, of which 353 were estimated to be appropriate. 

Study findings indicate a further need for “establishing a goal for outpatient antibiotic stewardship,” Dr. Fleming-Dutra added.

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