Antibiotic overuse exists

Two large studies carried out in the United States provide striking perspectives on the continuing problem of antibiotic overuse. Both articles were published online September 24 in the Archives of Internal Medicine.

Antibiotics in Older Adults –In the first article, the researchers studied  antibiotic prescribing among older adults  for the years 2007 through 2009. Across all regions, antibiotic prescribing peaked during the first quarter (January – March), at 20.9% of all visits.

Antibiotics for Sinusitis –In the other study, a group of researchers studied national trends in antibiotic prescribing for adults in the United States who were diagnosed with acute sinusitis. The principal finding was that even though most sinusitis is viral in origin and antibiotics are of little use in treatinantibioticg such infections, the prescribing of broad-spectrum antibiotics, such as quinolones and macrolides, is extremely common.

Tarayn Fairlie, MD, MPH, from the CDC, Atlanta, Georgia, and colleagues note that up until 2012, amoxicillin was the recommended empirical treatment for acute bacterial sinusitis. New guidelines now recommend amoxicillin-clavulanate. Using 2000 to 2009 data, it was found that
80% of patients diagnosed as having acute sinusitis receive an antibiotic, despite mounting evidence that the benefits of antibiotic treatment for sinusitis are limited,” the authors write.

More specifically, they found that antibiotics were prescribed in 83% of visits for acute sinusitis and that that rate of prescribing did not change significantly during the study period (P = .85). “Changes in prescribing behavior of health care providers for sinusitis are urgently needed to improve health care quality and stem the rising tide of antibiotic resistance in the United States,” the authors conclude.

“We need to find better ways to compel individuals and organizations to address the significance of the problem of antibiotic overuse and to increase the readiness for change and quality improvement of ambulatory practices in the United States,” they conclude.

Arch Intern Med. Published online September 24, 2012.


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