Physicians Overprescribe Antibiotics to Elderly Patients

Antibiotic-resistant bacteria have been spreading around the world and causing life-threatening infections. A large driver behind this trend is the overprescribing of antibiotics.

A new study published by the Annals of Internal Medicine suggests that nearly half of seniors who sought care from their primary care provider in 2012 received antibiotics for a non-bacterial infection. The authors also investigated specific characteristics of physicians prescribing these drugs.

"Unnecessary antibiotic use, such as antibiotic use for viral infections, is a major public health concern associated with avoidable adverse drug events, increased health care costs, and the emergence of antibiotic-resistant infections," said study author Marcus Povitz, MD.

Included in the study were 185,014 seniors who did not present a bacterial infection to their physician, making antibiotics clinically unnecessary. These patients visited their providers for non-bacterial upper respiratory infections — 53% of patients had a common cold, 31% had acute bronchitis, 14% had acute sinusitis, and 2% had acute laryngitis.

The authors discovered that 46% of patients were prescribed an antibiotic, despite it not being an appropriate treatment.

Approximately 70% of patients were prescribed a broad-spectrum antibiotic, which has been linked to Clostridium difficile infections, diarrhea, heart problems, tendon ruptures, allergic reactions, and other adverse events, according to the study. Additionally, this type of antibiotic is known to spread drug resistance, making overprescribing dangerous.

Interestingly, patients were more likely to receive an unnecessary antibiotic prescription if their physician has been in practice for more than a decade. This finding suggests that there should be an increased importance on educating physicians about the dangers of drug resistance. Physicians who were trained outside of Canada or the United States were also more likely to prescribe antibiotics for a non-bacterial infection, according to the study.

The authors also discovered that physicians with a high number of patients were likely to prescribe antibiotics unnecessarily. These physicians may not be taking the time to properly diagnose patients to ensure that they meet all of their appointments.

The authors suggest that targeted interventions could be developed to reduce inappropriate antibiotic prescriptions, according to the study.

Another study found that social media sites may be an effective way to educate younger physicians about the proper use of antibiotics and other antimicrobial drugs. These platforms can also encourage medical residents to use antimicrobial stewardship program resources to increase education among all internal residents and may reduce drug resistance. This initiative is relatively inexpensive and would reach a vast majority of providers.

"Our study shows that antibiotics are being prescribed too often for conditions that they cannot help despite published professional guidelines that discourage this practice. Unnecessary antibiotics can cause serious harm," said study author Michael Silverman, MD.