Inappropriate antibiotic prescriptions dropped early in pandemic, rebounded in 2021
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Key takeaways:
- The monthly proportion of Americans receiving inappropriate antibiotic prescriptions declined after March 2020.
- Rates returned to pre-pandemic levels by December 2021.
The average number of inappropriate antibiotics prescribed monthly decreased at the start of the COVID-19 pandemic but returned to pre-pandemic levels by late 2021, data show.
“Antibiotic prescribing is a key driver of antimicrobial resistance, which kills 48,000 Americans per year,” Kao-Ping Chua, MD, PhD, assistant professor of pediatrics and assistant professor of health management and policy at the University of Michigan Medical School, told Healio. “We conducted our study to determine whether the appropriateness of antibiotic prescribing changed after the COVID-19 pandemic began in March 2020.”
Chua and colleagues performed an interrupted time series analysis of Optum’s Clinformatics Data Mart Database, a national commercial and Medicare Advantage claims database. All prescriptions for antibiotics dispensed to children and adults enrolled during each month between 2017 and 2021 were included and assessed. The researchers applied a previously developed antibiotics appropriateness classification scheme on medical claims reported on or during the 3 days before dispensing. Study outcomes included the monthly proportion of inappropriate antibiotic prescriptions and the monthly proportion of enrollees with one or more inappropriate prescriptions.
In total, the study assessed more than 37 million enrollees, among whom the monthly proportion of inappropriate antibiotic prescriptions decreased after March 2020, but rebounded to pre-pandemic levels by late 2021.
Specifically, the study showed the overall proportion of patients with one or more inappropriate prescription decreased 0.8 percentage points in March 2020 (95% CI, 1.09% - 0.51%) and then subsequently increased 0.02 percentage points per month after (95% CI, 0.01% – 0.03%).
This was “largely because fewer Americans received antibiotics in general” during this time, Chua said.
By December 2021, however, the proportion of enrollees with one or more inappropriate antibiotic prescriptions had rebounded to pre-pandemic levels. Chua attributed this largely to high rates of inappropriate prescribing for COVID-19 infections.
“Our findings reiterate the continued importance of investing in initiatives to prevent inappropriate antibiotic prescribing,” he concluded.
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