One-in-four antibiotic prescriptions unwarranted

Despite years of dire warnings on dangers of antibiotic resistance, from leading health organizations, including the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) in the United States, doctors continue to dole out antibiotics.

A new study into the liberal dispensation of antibiotics by doctors found that nearly 25 percent of the prescriptions were unwarranted. One out of seven participants in the study were found to have received antibiotics inappropriately, based on the associated diagnosis.

Researchers sifted through the data of more than 15 million antibiotic prescriptions from insurance and claims data associated with 19 million privately insured people in the United States. Using International Classification of Diseases (ICD) codes (medical billing codes used to describe disease), the study team then developed a classification system for when antibiotics should be appropriately prescribed.

They created a three-tier system of ‘always’ (if the associated condition almost always requires antibiotics), ‘sometimes’ (if the condition has a potential indication for antibiotics), and ‘never’ (when the indication almost never calls for antibiotics). For example, bacterial pneumonia and strep throat (streptococcal pharyngitis) almost always require antibiotics, whereas viral pneumonia and chronic rhinitis rarely do.

The problem appeared in the numerous diagnoses in the ‘sometimes’ category that lead to cases in which prescribing an antibiotic may or may not be the right thing to do. The researchers said they could only be confident on 13 percent of the ‘sometimes’ category did require antibiotic prescription. While the other 87 percent might not be inappropriate, existing data suggest that the appropriateness of those prescriptions were not very high.

This study is not the first to confirm that overprescribing antibiotics is a major issue in the healthcare system. A report issued by the CDC in 2016 found that one in three antibiotic prescriptions was unnecessary. Clearly, there is a need for a cultural shift in the way people consider antibiotics as the answer to most of their ailments.

The WHO calls antibiotic resistance — which is the process through which bacteria become resistant or immune to antibiotics — “one of the biggest threats to global health, food security, and development today.” Instances of antibiotic resistant superbugs including pneumonia, tuberculosis, gonorrhea, and salmonellosis have already been documented. And, antibiotic overuse is a major driver of antibiotic resistance. It is up to doctors to stop prescribing antibiotics unnecessarily, for the sake of patients and society in general.