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The Importance of Antibiotics Stewardship
Antibiotics resistance is known as a major public health concern. According to the most recent Centers for Disease Control and Prevention Antibiotic Threats Report, the issue causes more than 2.8 million infections and about 36,000 deaths in the U.S. each year. Despite this, physicians continue to overprescribe the drugs—particularly among seniors and minority populations.
In fact, a study by University of Texas Health Science Center in San Antonio found that antibiotics prescribing rates were highest among Black and Hispanic patients, females and individuals under 18. Notably, 64% of antibiotics for Black patients, 58% of those for Hispanic patients and 74% of those for people ages 65 and over were considered “inappropriate” by researchers. These prescriptions were most often written for conditions unrelated to bacterial infections, including skin disorders, viral respiratory tract infections and bronchitis.
“Our results suggest that Black and Hispanic patients may not be properly treated and are receiving antibiotic prescriptions even when not indicated,” says lead author Eric Young, Ph.D.
The consequences of this issue are severe, he explains: “In older adults, inappropriate prescribing in primary care is associated with a wide range of adverse outcomes, including emergency hospital attendances and admissions, adverse drug events and poorer quality of life.”
Why Are Antibiotics Overprescribed?
In a presentation at the 2022 annual Internal Medicine Meeting of the American College of Physicians summarized by MDedge, James “Brad” Cutrell, MD, of University of Texas Southwestern Medical Center, Dallas, described three factors he believes contribute to overuse:
- physician fear of missing an infection;
- patient expectations to leave the office with a prescription; and
- overemphasis on the potential benefit of antibiotics.
How Can Physicians Mitigate Overprescription of Antibiotics?
Cutrell advocates for a new culture around antibiotic use. “We need more respect for the dangers of antibiotic misuse and to have confidence in [their] benefits and when they can be used wisely,” he explains. According to Young, strategies to reduce inappropriate prescribing must be tailored for outpatient settings.
To promote antimicrobial stewardship in the outpatient setting, Cutrell recommends:
- making a commitment to optimize prescribing;
- implementing at least one policy or practice to prevent overprescribing;
- monitoring prescribing practices & providing clinician feedback; and
- providing clinician and patient education on the subject.
He also says that displaying commitment posters around the clinic can help promote a better culture around antibiotic use.
In addition, MLMIC encourages our insureds to explore our existing resources on this topic:
