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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Appropriateness of Antibiotic Prescribing in US Emergency Department Visits, 2016-2021

Joseph Benigno Ladines-Lim1, Michael A Fischer2, Jeffrey A Linder3

  • 1Departments of Internal Medicine and Pediatrics, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA.

Antimicrobial Stewardship & Healthcare Epidemiology : ASHE
|May 16, 2024
PubMed

Insights

Nearly 30% of US emergency department visits involved inappropriate antibiotic prescribing from 2016-2021. This included actual overuse for conditions like acute bronchitis and potential errors due to inaccurate diagnosis coding.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Health Services Research

Background:

  • Antibiotic resistance is a major global health threat.
  • Inappropriate antibiotic prescribing contributes to resistance and adverse events.
  • Understanding prescribing patterns in emergency departments is crucial.

Purpose of the Study:

  • To analyze the rates and types of inappropriate antibiotic prescribing in US emergency departments.
  • To identify potential drivers of inappropriate prescribing, including diagnostic coding quality.

Main Methods:

  • National analysis of emergency department visits data from 2016-2021.
  • Categorization of inappropriate prescribing into actual overuse and potential coding errors.

Main Results:

  • 27.6% of analyzed visits showed inappropriate antibiotic prescribing.
  • 14.9% involved plausible antibiotic-related diagnoses, indicating actual overuse.
  • 12.6% had non-antibiotic-related diagnoses, suggesting poor coding quality.

Conclusions:

  • A significant proportion of emergency department antibiotic prescriptions are inappropriate.
  • Both actual overuse and diagnostic coding inaccuracies contribute to this issue.
  • Interventions are needed to improve antibiotic stewardship and diagnostic accuracy in emergency settings.

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