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Q&A: Campaign fights Kentucky’s high rates of antibiotic prescriptions
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A new public health awareness campaign is focusing on antibiotic overuse in Kentucky, the U.S. state with the highest rate of antibiotic use.
The campaign, called Kentucky Antibiotic Awareness, is led by researchers from the University of Louisville department of pediatrics’ Child and Adolescent Research Design and Support Unit, with funding support from the state’s Department for Medicaid Services. According to a news release, the program aims to provide education and resources to health care providers and the public.
In 2016, the rate of outpatient antibiotic prescriptions for patients of all ages in Kentucky was 1,270 per 1,000 population compared with 836 per 1,000 population in the U.S., according to CDC data included in the news release For children, the rate was 1,331 outpatient antibiotic prescriptions per 1,000 population in Kentucky compared with a national rate of 790 per 1,000 population.
Infectious Disease News spoke with Bethany Wattles, PharmD, a clinical pharmacist in the University of Louisville department of pediatrics, to discuss the new campaign. – by Bruce Thiel
Why does Kentucky have the highest antibiotic prescribing rate in the U.S. ?
We have identified through quantitative research with the pediatric Kentucky Medicaid pharmacy claims that the rate is significantly higher in the eastern side of the state, about three times higher than the national average. It seems that it could be related to the rural nature of these areas, but we are not sure if there is a higher disease burden, or if it is a result of patient demand, educational differences or other factors. We are in the process of conducting interviews with providers and patients in that area to find out more information about the culture behind antibiotic use. The more urban areas of Kentucky, including Louisville, Lexington and Northern Kentucky, are closer to the national average, based on pharmacy claims data. There are probably multiple reasons to why the eastern side of the state has higher prescribing.
How does this break down for children compare with that of adults?
According to the 2016 data from the CDC on outpatient antibiotic use, Kentucky has a much higher rate of antibiotic use than the national average for both children and people of all ages. Overall, children are prescribed a lot of antibiotics, and this is true in other parts of the country. However, we have a large discrepancy compared to the national average, so there may be more of a problem of inappropriate use here.
What is being done to combat this?
Through our statewide campaign, we are trying to bring resources related to appropriate antibiotic use to both providers and patients. For providers, we want to help them in establishing stewardship initiatives in their practice. We have created a workbook that walks providers through the CDC’s Core Elements of Antibiotic Stewardship and how to implement stewardship initiatives. We are also providing resources specific to Kentucky, like our social media accounts and campaign listserv to keep them up to date with newsletters and updates.
Have you had success?
It is fairly new — we went live with our website and social media sites in September. We have been trying to get around the state to conduct education programs at various conferences. We have reached out to professional organizations to get the word out through their newsletters. We have had a steady increase in our listserv and social media followers but we are definitely hoping to get more involvement. We would like providers throughout the state to know about the Kentucky Antibiotic Awareness campaign.
References:
CDC. Measuring Outpatient Antibiotic Prescribing. https://www.cdc.gov/antibiotic-use/community/programs-measurement/measuring-antibiotic-prescribing.html
Disclosures: Wattles reports no relevant financial disclosures.
Disclaimer: Wattles noted that her comments do not necessarily represent the official views of the Kentucky Cabinet for Health and Family Services, Department for Medicaid Services.