Antibiotics Overprescribed for Respiratory Tract Infections

A study published in the February 2015 issue of Infection Control & Hospital Epidemiology found that antibiotics were inappropriately prescribed to 45% of patients with respiratory tract infections in an outpatient setting.

The retrospective analysis included 4942 outpatient visits among patients who sought care for respiratory tract infections at a general internal medicine and family medicine practice at Boston Medical Center over a 2-year period.

Among the cases examined, 71% received antibiotics for bronchitis, 50% for sore throat, and 28% for non-specific upper respiratory tract infections. The researchers noted that these conditions often do not require antibiotic interventions.

The investigators also determined that women were prescribed antibiotics more often than men, and that overprescribing occurred more frequently among white patients than black patients.

“It is concerning that there may be a different approach to patients depending on race of gender, which may suggest inequities in care,” said lead study author Tamar Barlam, MD, director of the antimicrobial stewardship program at Boston Medical Center, in a press release.

Incorporating antimicrobial and stewardship education during medical school may subdue inappropriate prescribing, the researchers said. They also recommended enlisting low prescribers as leaders alongside high prescribers to influence prescribing practices.

“Physicians’ inappropriate prescribing patterns appeared to differ by medical specialty and to be established early, likely during medical school or residency,” Dr. Barlam said. “Instituting aggressive interventions in training or practice at the right time and to the right physicians could improve antibiotic use and efficacy of antibiotic stewardship in outpatient settings.”