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In study, many cancer patients prescribed unnecessary antibiotics
Nearly one-third of hematology-oncology patients at one Seattle cancer treatment center were prescribed antibiotics for upper respiratory infections despite respiratory viruses being detected in most tested patients, according to study findings.
“Antibiotics are frequently prescribed for upper respiratory tract infections (URI) despite viral etiologies for the majority of these illnesses. In the United States, the estimated annual rate of outpatient antibiotic prescriptions for acute respiratory conditions is 221 per 1,000 people, and of these, approximately 50% are considered inappropriate. As such, the CDC and other national organizations have highlighted antibiotic use for acute URI as a key target for antimicrobial stewardship,” Elizabeth M. Krantz, MS, of the vaccine and infectious disease division at Fred Hutchinson Cancer Research Center in Seattle, and colleagues wrote.
“Most studies describing antibiotic prescribing for acute URI have focused on general medical or pediatric populations. Little is known about antibiotic prescribing practices for URI among ambulatory cancer patients.”
Krantz and colleagues conducted a retrospective cohort study of patients at Seattle Cancer Care Alliance with a URI diagnosis code between Oct. 1, 2015, and Sept. 30, 2016. They collected antimicrobial prescribing, respiratory viral testing and other data at first encounter of the URI through day 14.
Results showed that of 251 patients eligible for analysis, 32% were prescribed antibiotics for URI. According to the study, respiratory viruses were detected among 75% of the 113 patients who received viral diagnostic testing. Krantz and colleagues found that sputum production or chest congestion was associated with higher risk for antibiotic prescribing (RR = 2.3; 95% CI, 1.4-3.8), whereas viral testing on day 0 was associated with a lower risk of antibiotic prescribing (RR = 0.4; 95% CI, 0.2-0.8).
“In conclusion, we found that nearly one in three patients seen at an ambulatory cancer center [was] prescribed antibiotics for URI. Viral etiologies were identified in the majority of patients who were tested, and testing itself was associated with decreased antibiotic usage,” they concluded. “Antibiotic prescription was not linked to subsequent URI-related health care visits. These findings highlight the need for further research to explore the role and cost-effectiveness of molecular respiratory viral testing in limiting unnecessary antibiotic use among hematology-oncology patients.” – by Caitlyn Stulpin
Disclosures: Krantz reports receiving research funding from Global Life Technologies Corp. Please see the study for all other authors’ relevant financial disclosures.