Inappropriate identification of antibiotic prescriptions in safety-net populations

THURSDAY, May 30, 2024 (HealthDay News) — Inappropriate antibiotic prescribing is common with or without a plausible indication for antibiotics, and inappropriate prescribing is also common during emergency room visits in the United States, according to a study published online on April 26 in the Journal of General Internal Medicine and a second study published on May 14 in Antimicrobial Stewardship and Healthcare Epidemiology.

Joseph B. Ladines-Lim, MD, PhD, of the University of Michigan in Ann Arbor, and colleagues examined differences in inappropriate prescribing with or without a plausible indication between safety-net and those not benefiting from a safety net. The analyzes covered 67,065,108 and 122,731,809 weighted visits for children and adults, respectively. The researchers found that the prevalence of inappropriate antibiotic prescribing was 11.7 and 22.0 percent, respectively, with plausible indication, among children in safety net and non-safety net populations, and 11.8 and 8.6 percent, respectively, without plausible indication. For adults, the corresponding prevalence was 12.1 and 14.3 percent and 48.2 and 32.3 percent.

In a second study, Ladines-Lim and colleagues used national data on emergency department visits from 2016 to 2021 to estimate the proportion of visits with inappropriate antibiotic prescribing. There were 819,395,799 weighted emergency department visits; 18.6 percent of these visits included one or more antibiotic prescriptions. The researchers found that 27.6 percent of visits with antibiotic prescriptions had an inappropriate prescription, with 14.9 and 12.7 percent, respectively, with and without a plausible antibiotic indication. Among visits with inappropriate antibiotic prescription, 54.0 and 46.0 percent had and did not have a plausible indication for antibiotics, respectively.

“Emergency department antibiotic stewardship initiatives should focus on both reducing the prescribing of antibiotics for inappropriate infectious conditions and improving the quality of coding of antibiotic prescriptions,” write the authors of the second study.

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