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Antibiotic prescription rate highest in South
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The rate of outpatient antibiotic prescriptions in 2011 was highest in the South census region among all age groups, researchers from the CDC reported in Clinical Infectious Diseases.
“Not surprisingly, the largest proportion (24%) of antibiotics in the United States were prescribed by family practitioners,” Lauri A. Hicks, DO, an epidemiologist at the CDC, told Infectious Disease News. “However, we were somewhat surprised that 10% of all antibiotic prescriptions were prescribed by dentists, a group of providers that has not been included in appropriate antibiotic use educational campaigns and programs to date.”
Hicks and colleagues used data from the IMS Health Xponent database to analyze antibiotic prescribing patterns in the United States in 2011. They examined the number of prescriptions, the antibiotics prescribed and the provider specialty. County-level census data were used to calculate the per-capita prescribing rates.
Lauri A. Hicks
There were 262.5 million courses of antibiotics prescribed in 2011, a prescribing rate of 842 per 1,000 persons. Overall, penicillins were the most common antibiotic category prescribed, accounting for 60.3 million prescriptions, followed by macrolides (59.1 million). The most common antibiotic prescribed was azithromycin (54.1 million prescriptions). Among children, penicillins were the most widely prescribed category, and amoxicillin was the most commonly prescribed agent. Macrolides were the most commonly prescribed category among adults; azithromycin was the most commonly prescribed agent.
The South saw the highest rate of antibiotic prescriptions: 108 million prescriptions, for a rate of 931 prescriptions per 1,000 persons. Hicks said that some states in the South census region, specifically the Appalachian region, had antibiotic prescribing rates that were more than double the state prescribing rates in the West census region.
Family practitioners prescribed the most courses (64.1 million), followed by pediatricians (32.4 million) and internists (32.1 million). These specialties comprised almost half of the antibiotic prescriptions. Of the remaining specialists, dentists prescribed 25.6 million courses.
Hicks said that these data did not change significantly from previous data in 2010. However, for 2011, they evaluated some factors that may explain the variation in antibiotic prescribing across the country. They found that counties with higher prescribing rates also had higher rates of obesity and more providers per population. In addition, counties with more females had higher prescribing rates.
“While studies have shown some improvement in antibiotic prescribing rates in the outpatient setting over time, there is still a lot of opportunity for improvement,” Hicks said. “The higher rates of prescribing in the South suggest something different about the patient or provider population and this warrants further study to better understand the types of interventions that may be most useful.”– by Emily Shafer
Disclosure: One researcher reports being an employee of IMS Health.
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