December 2017
Working Together to Stop Antibiotic Resistance
According to a PEW Charitable Trusts report regarding antibiotic use in outpatient settings, 30 percent of antibiotics are determined to be unnecessary for treating the prescribed condition (e.g., prescribing antibiotics for viral illnesses, asthma exacerbations, etc.).1 Additionally, the Centers for Disease Control and Prevention (CDC) reports up to 50 percent of antibiotics are not optimally prescribed in terms of choosing an appropriately focused antibiotic for the condition being treated.2 These prescribing behaviors contribute to increasing bacterial resistance, which in combination with the relatively lesser availability of new antibiotics to combat these resistant organisms, have been associated with at least 2 million illnesses and 23,000 deaths nationwide.2
A new report from the Blue Cross and Blue Shield Association similarly found that 20 percent of nationally prescribed outpatient setting antibiotics are not indicated. While outpatient antibiotic prescriptions for commercially insured people are moving in the right direction nationwide by decreasing 9 percent from 2010 to 2016, individual state performance data is more variable. Antibiotic prescribing in Illinois, for example, has increased 3 percent over this same time frame with some regional areas experiencing increases as high as 36 percent.
In 2015, the White House released a national action plan for combating antibiotic resistance that includes the goal of reducing inappropriate outpatient antibiotic use by 50 percent by 2020.3 Blue Cross and Blue Shield of Texas is doing its part by evaluating the antibiotic prescribing patterns of contracted practitioners. Approximately 120 Texas primary care practitioners were identified for prescribing patterns that significantly deviated from their same-specialty peers. Further analysis found that their antibiotic choice may not be in accordance with recommended practice guidelines. Feedback was provided to these practitioners highlighting potential areas for improvement.
As a health care provider, there are antibiotic stewardship initiatives you may want to consider, including:
- Evaluating your prescribing habits.1
- Discussing appropriate antibiotic use and potential risks such as adverse side effects with your patients.
- Confirming a diagnosis of bacterial infection before prescribing an antibiotic.
- Re-directing your patient’s expectations if antibiotics are not warranted
- Offering your patients advice and specific recommendations for symptom relief. Include ways to help the rest of their family keep from getting sick.
- Offering your patients a contingency plan if symptoms do not improve. Leaving the door open for future treatment may help maintain patient satisfaction.
The following graph shows unnecessary vs. appropriate use of antibiotics by health condition.
For additional information visit the American Academy of Family Practice and the CDC.
Sources:
1Antibiotic use in outpatient settings. (2016). Retrieved from http://www.pewtrusts.org/en/research-and-analysis/reports/2016/05/antibiotic-use-in-outpatient-settings
2Center for Disease Control (2017). About Antimicrobial Resistance. Retrieved from https://www.cdc.gov/drugresistance/about.html
3National action plan for combating antibiotic resistant bacteria. (2015). Retrieved from https://obamawhitehouse.archives.gov/sites/default/files/docs/national_action_plan_for_combating_antibotic-resistant_bacteria.pdf