Pilot Program Succeeds in Reducing Unnecessary Antibiotic Prescriptions, Study Finds

Overuse of antibiotics for conditions they are unable to treat is a global health concern, leading to a rise in drug-resistant "superbug" infections.

Researchers indicate that a new national educational program implemented at hundreds of medical centers could help curb the unnecessary prescription of antibiotic medications, particularly those given to treat viruses, which are unaffected by antibiotics.

A pilot program conducted by the Agency for Healthcare Research and Quality (AHRQ) at 389 ambulatory care centers was found to reduce inappropriate antibiotic prescriptions overall, as well as reduce unnecessary antibiotics for viral infections that cannot be treated with any antibiotics, according to findings presented at virtual IDWeek.

Researchers conducted the National Antibiotic Stewardship program at facilities which were part of the AHRQ’s effort for improving antibiotic use, and the study involved data on more than 6 million patient visits.

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Roughly 35% of centers studied were primary care centers, 48% were urgent care clinics, 12% were federally funded practices, and 5% were specialty clinics which included primary care services.

Researchers compared data from the pre-intervention period, September to November 2019, with the post-intervention period, December 2019 to November 2020.

Overall, researchers say the program helped to reduce antibiotic prescriptions from 19 per 100 visits to 10 per 100 visits. Additionally, prescriptions for acute respiratory infections dropped from 40 per 100 visits to 25 per 100 visits.

Researchers also noted a large reduction in antibiotic prescriptions of penicillin class antibiotics. Those dropped to seven fewer for every 100 visits.

AHRQ is a national program which involves presentations, webinars, patient handouts, and other educational tools that focus on three key areas for doctors: developing and improving antibiotic stewardship; learning strategies for discussing antibiotic prescribing with colleagues, patients, and their families; and best practices for diagnosing and managing common infectious syndromes, as well as allergies to antibiotics.

One important part of the program was allowing clinicians to talk to each other about prescribing, including with office and rooming staff, so when patients have viral infections, the entire staff is empowered to address the inappropriateness of using antibiotics in those cases.

The acute respiratory infections in the study were primarily viral respiratory tract infections, like bronchitis, which cannot be treated by antibiotics. These are some of the most common ailments for which antibiotics are prescribed.

Previous research has indicated doctors often overprescribe antibiotics for inappropriate reasons, many ailments that cannot be treated by antibiotics. Yet, antibiotics are often prescribed more than half the time.

Patients who need antibiotics the most for ailments that can be treated with antibiotics should receive it for the shortest effective duration in order to reduce the proliferation antibiotic resistant bacteria, health experts advise.

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