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Provider Bad Practices Fuel Inappropriate Antibiotic Prescribing

February 05, 2018

Provider Bad Practices Fuel Inappropriate Antibiotic Prescribing

A just-released study has revealed that inappropriate antibiotic prescriptions are linked to bad practices by providers.  The study was conducted by Monica Schmidt, PhD, and colleagues from the Center for Outcomes Research and Evaluation in Charlotte, North Carolina.  They reviewed electronic medical record data from nearly 450,000 outpatient appointments at Carolinas HealthCare System’s urgent care centers and family, internal medicine, and pediatric practices.

The review -- which looked into the behaviors of nearly 900 providers and 250 practices -- focused on four conditions for which antibiotics are typically not indicated. The diagnoses were: acute upper respiratory infection, acute bronchitis, bronchiolitis, and nonsuppurative otitis media.

Antibiotics Prescribed Inappropriately at a Rate of 40%

In general, the researchers found that for every 1000 patients seen, antibiotics were inappropriately prescribed 407 times by all varieties of providers. This alone is alarming, as unnecessary antibiotics don’t make sick patients healthy, but do put them and others at serious risk.

Bronchitis was the most common diagnosis of inappropriate antibiotic prescriptions.  For every 1000 patients seen with this condition, 703 prescriptions for antibiotics were written. And more often than not, these inappropriate bronchitis prescriptions were for azithromycin (Z-Pak).

Wrote Monica Schmidt in her study, PhD: “Previous studies and our results suggest that patient and provider education on appropriate prescribing for bronchitis, including guidance on correct use of azithromycin, may be an effective way to reduce prescribing rates.”

For Viral Infections, Antibiotics Just Won’t Help

The researchers suggest education is a primary tool in reducing the inappropriate usage of antibiotics. These powerful medicines treat bacterial infections -- not viral ones -- and using antibiotics inappropriately puts us all at risk of drug-resistant infections.

Not sure of the difference between bacterial and viral infections? Bacteria are found all over our environment: in our food, in our bodies, and lots of other places. Strep throat and urinary tract infections both constitute bacterial infections, and these ailments may be treated with antibiotics. Viral infections require a living host to multiply and survive. Viral infections include common colds, the flu, and bronchitis. They cannot be treated with antibiotics.

Since you cannot use antibiotics to treat viral infections, here are some tips and tricks to help prevent them:

  • Get plenty of sleep
  • Adequate hydration
  • Practice proper hand-washing technique
  • Avoid sick people when possible

Ask Questions About Your Prescriptions

What’s the grand takeaway from this study? The study shows us that far too many healthcare professionals are prescribing antibiotics when they are not needed. Any time a provider prescribes you with an antibiotic, ask for more information about how this prescription will help you and what bacterial infection the medication is intended to treat. Don’t be afraid to speak up and verify if your antibiotic prescription is necessary.





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