Study analyzes variations in antibiotic prescribing among older patients

September 24, 2012

A study of Medicare data suggests there was wide variation in antibiotic prescribing for older patients based on geography and the season in which the prescriptions for the medication were written, according to a report published Online First by Archives of Internal Medicine.

The is common and can lead to unnecessary spending on , as well as increase the risk for adverse effects and antimicrobial resistance, according to the study background. "Findings on variation in can guide policy efforts to improve more targeted areas or specific therapeutic subclasses of antibiotics," the authors comment.

Yuting Zhang, Ph.D., of the University of Pittsburgh, and colleagues used data from 2007 through 2009 (comprising about 1 million patients per year) to examine in antibiotic use among older adults in 306 hospital referral regions, 50 states and the District of Columbia, and four national regions (South, West, Midwest and Northeast). They also studied quarterly change in antibiotic use across the four regions.

The highest antibiotic use was in the South and the lowest was in the West. In the South, 21.4 percent of patients per quarter used an antibiotic whereas 17.4 percent of patients per quarter used an antibiotic in the West. The rate in the Midwest was 19.2 percent, according to the study results.

Researchers also report that, regardless of region, the rate of antibiotic use was highest in the first quarter of the year (20.9 percent, January through March) and lowest during the third quarter (16.9 percent, July through September).

"Overall, areas with high rates of antibiotic use may benefit from more targeted programs to reduce unnecessary antibiotic use. Although antibiotic use in the regions with lower use does not necessarily represent the clinically appropriate use given that overuse of antibiotics is common, quality improvement programs set attainable targets using the low-prescribing areas (i.e. the states in the West) as a reference," the authors note.

Researchers conclude: "Although older adults may have higher risk for adverse outcomes from infection, they may also be at particularly high risk for adverse outcomes from . Therefore, it might be necessary to target some quality improvement initiatives toward this age group."

In an invited commentary, Ralph Gonzales, M.D., M.S.P.H., of the University of California, San Francisco, and colleagues write: "We believe that the persistence of antibiotic overuse in the United States is a failure to translate national public health priorities and evidence into local practice and policies."

"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 continue.

"Strategies to achieve transformation at these levels may need to differ substantially from the current educational approaches that have been in use among patients and clinicians thus far," they conclude.

Explore further: Study hints at antibiotic overuse in home-care patients

More information:
Arch Intern Med. Published online September 24, 2012. doi:10.1001/archinternmed.2012.3717
Arch Intern Med. Published online September 24, 2012. doi:10.1001/2013.jamainternmed.532

Related Stories

Study hints at antibiotic overuse in home-care patients

June 15, 2011
A study of Canadian home-care patients suggests doctors may be overprescribing antibiotics for patients receiving ongoing medical care at home. The study, published in the June issue of Infection Control and Hospital Epidemiology, ...

Common antibiotic can have serious adverse reactions

October 11, 2011
trimethoprim-sulfamethoxazole – that has been used since 1968 can cause serious adverse reactions and physicians need to be aware of these in prescribing, states a review in CMAJ (Canadian Medical Association Journal).

Simple guidelines decreased unnecessary antibiotic use in Quebec, Canada

July 26, 2011
Antibiotic overuse and resistance have emerged as major threats during the past two decades. Following an outbreak of Clostridium difficile infections, which often result from antibiotic use, health care professionals in ...

Antibiotics often the wrong prescription for pediatric asthma

June 1, 2011
(Medical Xpress) -- At nearly one in six pediatric asthma visits, antibiotics are prescribed as a remedy, despite national guidelines against the practice. Ian Paul, departments of pediatrics and public health sciences, Penn ...

Recommended for you

Mind-body therapies immediately reduce unmanageable pain in hospital patients

July 25, 2017
Mindfulness training and hypnotic suggestion significantly reduced acute pain experienced by hospital patients, according to a new study published in the Journal of General Internal Medicine.

Study suggests ending opioid epidemic will take years

July 20, 2017
The question of how to stem the nation's opioid epidemic now has a major detailed response. A new study chaired by University of Virginia School of Law Professor Richard Bonnie provides extensive recommendations for curbing ...

Team-based model reduces prescription opioid use among patients with chronic pain by 40 percent

July 17, 2017
A new, team-based, primary care model is decreasing prescription opioid use among patients with chronic pain by 40 percent, according to a new study out of Boston Medical Center's Grayken Center for Addiction Medicine, which ...

Private clinics' peddling of unproven stem cell treatments is unsafe and unethical

July 7, 2017
Stem cell science is an area of medical research that continues to offer great promise. But as this week's paper in Science Translational Medicine highlights, a growing number of clinics around the globe, including in Australia, ...

Popular heartburn drugs linked to higher death risk

July 4, 2017
Popular heartburn drugs called proton pump inhibitors (PPIs) have been linked to a variety of health problems, including serious kidney damage, bone fractures and dementia. Now, a new study from Washington University School ...

Most reproductive-age women using opioids also use another substance

June 30, 2017
The majority of reproductive-age and pregnant women who use opioids for non-medical purposes also use at least one other substance, ranging from nicotine or alcohol to cocaine, according to a University of Pittsburgh Graduate ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.