Outpatient antibiotic prescriptions for ARIs decreased in recent years
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The rate of antibiotic prescriptions for acute respiratory infections “decreased modestly” between 2011 and 2018, according to researchers, who noted that still more reductions are needed.
“In 2016, CDC published [a study] which established a baseline for unnecessary outpatient antibiotic prescribing and provided a tiered classification system to assess the antibiotic-appropriateness based on ICD-9-CM diagnostic codes,” Lauri A. Hicks, DO, director of the CDC' s Office of Antibiotic Stewardship, told Healio.
“Our study updates the 2016 study by describing acute respiratory infection (ARI) visits and antibiotic prescriptions in outpatient settings in 2011 and 2018 in order to evaluate the progress made in reducing unnecessary antibiotic prescribing for ARIs,” Hicks said.
For the study, Hicks and colleagues calculated the annual number of ARI visits and visits with oral antibiotic prescriptions per 1,000 enrollees overall, as well as by age category, sex and setting in 2011 and 2018 and compared the prevalence rate ratios (PRRs).
They found that there were 829 ARI visits per 1,000 enrollees in 2011 compared with 760 ARI visits per 1,000 enrollees in 2018. Among ARI visits, 39.3% in 2011 and 36.2% in 2018 were associated with one or more oral antibiotic prescription, they reported. Additionally, the study showed that ARI visits overall decreased 8% (PRR = 0.92; 99.99% CI, 0.92-0.92), whereas visits with antibiotic prescriptions decreased 16% (PRR = 0.84; 99.99% CI, 0.84-0.85) in 2018 compared with 2011.
The researchers also found that visits for antibiotic-inappropriate ARIs decreased by 9% (PRR = 0.91; 99.99% CI, 0.91-0.92), and visits with antibiotic prescriptions for these conditions decreased by 32% (PRR = 0.68; 99.99% CI, 0.67-0.68) from 2011 to 2018.
“Decreases in antibiotic prescribing were driven by decreases in prescribing for pharyngitis and ARIs for which antibiotics are not appropriate, suggesting that overall decreases in antibiotic prescribing for ARIs reflect improved prescribing practices rather than just changes in diagnostic patterns,” Hicks said. “However, despite these decreases in antibiotic prescribing, opportunities for improvement still remain.”
Hicks added that “continued outpatient antibiotic stewardship is needed to further improve antibiotic prescribing for ARIs and optimize patient care.”
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