Hospital antibiotic use “unsupported” in 56% of patients

Posted: 8th April 2021

A US study into antibiotic prescribing in hospitals has found that the drugs were misused in 56% of cases. In many cases, doctors had prescribed the wrong antibiotic or advised the patient to take the medicine for longer than necessary. In response, the influential Pew Institute has established new guidelines designed to improve hospital antibiotic prescribing.

Antibiotics are crucial to our health and wellbeing and are a vital weapon in our battle against bacteria and infections. There is growing concern that over-prescribing of antibiotics could lead to antimicrobial resistance (AMR). AMR occurs when bacteria, viruses, fungi and parasites no longer respond to medicines.

The World Health Organization considers AMR to be one of the most serious threats to our global health and wellbeing. There are more than 2.8 million AMR infections in the USA every year, causing almost 40,000 deaths – and the risk is increasing. These untreatable infections pose a considerable threat to our welfare and could render our current crop of antibiotics useless.

Medical professionals across the world are being encouraged to prescribe fewer antibiotics. However, even today, 30% of American hospital patients are prescribed at least one antibiotic. But is it necessary?

Researchers from the Centers for Disease Control and Prevention (CDC) set out to explore precisely what percentage of hospital antimicrobials are prescribed and used appropriately. To answer the question, they analysed patient data from hospitals in 10 US states. Specifically, they investigated prescriptions made for community-acquired pneumonia (CAP) urinary tract infections (UTIs).

An analysis of the data found that 79% of prescriptions for CAP and 77% of treatments for UTIs were inappropriate. 

Researchers classified inappropriate prescribing in three ways. An antibiotic prescribed when the pathogen (bacteria) wasn’t susceptible, guidelines weren’t being followed, or the antibiotics were used for longer than recommended. In all three cases, antibiotic use could raise the risk of AMR and fail to treat the underlying condition.

The study results have influenced the Pew Institute to recommend new guidelines for the treatment of UTIs and CAPs in US hospitals.

More broadly, the research highlights a growing concern among healthcare professionals that antibiotics are being prescribed and taken inappropriately. The UK has made significant steps toward reducing antibiotic prescribing in primary and secondary care through the National Institute for Health and Care Excellence (NICE), but there is still work to do. 

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You can read the full paper, Assessment of the Appropriateness of Antimicrobial Use in US Hospitals, here