Outpatient antibiotic use declines by 9% in US

A large study of patient records showed that outpatient antibiotic use among commercially insured Americans has declined by 9% in recent years, with an even bigger drop observed for broad-spectrum antibiotics.

Blue Cross Blue Shield said it reviewed 173 million claims from 31 million members aged younger than 65 years and found that the number of filled antibiotic prescriptions per 100 members fell from 90.7 in 2010 to 82.6 in 2016 — an apparent sign that efforts to limit unnecessary use of antibiotics are having the desired effect.

The insurer published its findings around the same time that a study in Clinical Infectious Diseases showed that overall antibiotic spending in the U.S. declined 16.6% between 2010 and 2015.

“Public health efforts to increase the awareness of excessive antibiotic use and the threat posed by antibiotic-resistant bacteria appear to be achieving measurable results,” Blue Cross Blue Shield said in its report.

For its study, Blue Cross Blue Shield examined antibiotic prescriptions filled by members as a result of an outpatient visit, leaving out antibiotics administered as part of an inpatient visit.

According to the findings, the prescription fill rate for broad-spectrum antibiotics fell by 13% — the steepest decline among all types. Broad-spectrum antibiotics are often wrongly prescribed and work against a wide range of bacteria. They are more likely to lead to resistance than other antibiotics, making them “of greatest concern to public health professionals,” the report said.

The fill rate for broad-spectrum antibiotic prescriptions declined among all age groups, with the steepest fall seen among children aged 12 years and younger, including a 22% decline in infants aged younger than 1 year. The decline in overall antibiotic fill rates — including intermediate-, narrow-spectrum and reserved antibiotics — was 16% in children, including 22% in infants, compared with 6% in adults.

Blue Cross Blue Shield also studied geographic differences, noting that portions of Appalachia and the South had the highest prescription fill rates. Fill rates in rural areas were 16% higher than in urban areas for all antibiotics and 19% for broad-spectrum antibiotics.

“While progress has been made, further improvements surrounding antibiotic prescriptions are warranted,” the review stated. “In 2016, health care professionals prescribed antibiotics in more than 20% of outpatient visits where their use is not indicated to treat the condition. Broad-spectrum antibiotics are used in the majority of these cases.” – by Gerard Gallagher

Reference:

Blue Cross Blue Shield. Antibiotic prescription fill rates declining in the U.S. 2017. https://www.bcbs.com/sites/default/files/file-attachments/health-of-america-report/HoA.Antibiotics.Report.pdf. Accessed September 5, 2017.