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Changes in US Outpatient Antibiotic Prescriptions From 2011-2016
Laura M King1, Monina Bartoces1, Katherine E Fleming-Dutra1
1Office of Antibiotic Stewardship, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Summary
US outpatient oral antibiotic prescriptions declined 5% from 2011-2016. While pediatric antibiotic use decreased, adult use rose, and the use of broad-spectrum agents also declined, highlighting key areas for antibiotic stewardship.
Area of Science:
- Pharmacology and Public Health
- Infectious Disease Epidemiology
Background:
- Antibiotics are crucial but pose risks like resistance and adverse events.
- Outpatient antibiotic prescribing is a key target for antibiotic stewardship programs.
- Understanding trends in outpatient antibiotic use is vital for public health.
Purpose of the Study:
- To analyze trends in US outpatient oral antibiotic prescriptions between 2011 and 2016.
- To identify changes in the rates of antibiotic prescriptions across different age groups.
- To evaluate shifts in the spectrum of antibiotics prescribed.
Main Methods:
- Utilized national prescription dispensing data (IQVIA Xponent) from 2011-2016.
- Calculated annual prescription rates per 1000 persons.
- Employed Poisson and linear models to assess prescription rate changes and temporal trends.
Main Results:
- Overall outpatient oral antibiotic prescription rates decreased by 5% (877 to 836 per 1000 persons).
- Pediatric prescription rates fell 13%, while adult rates increased 2%.
- The ratio of broad- to narrow-spectrum antibiotics decreased, with notable reductions in macrolides and fluoroquinolones.
Conclusions:
- Outpatient antibiotic prescribing, particularly broad-spectrum agents, has shown a downward trend.
- Adult prescribers, including nurse practitioners and physician assistants, represent important targets for antibiotic stewardship initiatives.
- Continued monitoring of antibiotic prescribing patterns is essential for combating antimicrobial resistance.
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