Redundant, Unnecessary Antibiotics Drive Up Infection Risks, Costs: Study

Hospitals throughout the country appear to be increasingly treating illnesses with several different types of antibiotics, which may increase individuals’ risk of future infection, according to the findings of new research. 

In a study published on Wednesday in the medical journal Infection Control and Hospital Epidemiology, researchers published findings indicating that redundant antibiotic use in hospitals not only contributed to antibiotic resistance, but also increases healthcare costs across the country.

The research involved a retrospective analysis of inpatient hospital data from more than 500 hospitals in the United States, including data for patients discharged between January 1, 2008, and December 31, 2011.

Redundant antibiotic use, or use of more than one type of antibiotics at a time to treat a patient, was determined by pharmacy records. Patients who used multiple antibiotics for two or more consecutive days were included.

“Our study suggests that there may be pervasive use of redundant antimicrobial therapy within US hospitals,” said study authors.

Researchers found nearly 80% of the hospitals studied used overlapping antibiotic dose combinations. This represents more than 32,000 cases.

Unnecessary Antibiotic Risks

The study revealed doctors were prescribing unnecessary multiple doses of different antibiotics for several days, when only one type of antibiotic would have effectively treated the illness.

Dr. Arjun Srinivasan, of the U.S. Centers for Disease Control and Prevention, and co-author of the study, speculates this may happen when doctors are presented with unusual illnesses which they are unable to diagnose immediately.

When faced with a very ill and feverish patient, doctors will often give them multiple antibiotics to be safe, but then fail to take them off the unnecessary ones when a definitive diagnosis is received.

Most patients were still on multiple antibiotics for more than two days. Researchers tested for 23 different antibiotic combinations which should rarely be used together. Metronidazole and piperacillintazobactam accounted for more than half of all redundant cases.

Researchers found antibiotic overuse translated to nearly 150,000 days and contributes to resistance to antibiotics. This equates to more than $12 million in avoidable healthcare costs.

This is the first study of this kind to focus on antibiotic redundancy in the hospital, the researchers claim. Prior studies have focused on antibiotic prescriptions at doctors’ offices for viruses which cannot be treated by antibiotics.

A Harvard Medical School study published last year revealed doctors in the U.S. prescribe antibiotics six out of every 10 times a patient complains of a sore throat. Typically only one out of every 10 cases requires antibiotic treatment.

Overuse in both situations can contribute to the creation of treatment resistant bacteria, not only making it more difficult to treat illness in the future with antibiotics, but putting the public at risk. When bacteria is exposed to antibiotics when unnecessary, the bacteria can adapt creating resistance to new generations.