Antibiotic Prescribing Practices May Need an Update

Antibiotic resistance concerns lead to call for prescribing changes

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Antibiotics have become a common tool to help keep us healthy, but as concerns about antibiotic resistance grow, these medications may have to be approached in a new way.

In a new report, the Centers for Disease Control and Prevention (CDC) explored how antibiotics are used in US hospitals, and found that in some cases, their use may need to be reduced.

Health officials urged hospitals and patients to do their part to use these medications correctly.

"Wash your hands thoroughly and often, especially when visiting a hospital."

Although antibiotics can save lives, overuse of these medications can contribute to the growing problem of antibiotic-resistant infections and other complications.

According to the new report, in which the CDC examined antibiotic prescribing practices in US hospitals, over half of all patients in a US hospital will receive an antibiotic.

The most common infections resulting in an antibiotic prescription in US hospitals were lung infections (22 percent), urinary tract infections (14 percent) and infections suspected to be from drug-resistant Staphylococcus bacteria like MRSA (17 percent).

Prescribing practices for these antibiotics seemed to vary greatly from center to center, as the report also found that doctors in some hospitals prescribed three times as many antibiotics as doctors in other hospitals.

In some cases, antibiotic use in the hospital can leave patients prone to a Clostridium difficile infection, a common healthcare-associated infection that causes diarrhea and can sometimes be serious and even deadly.

"Decreasing the use of antibiotics that most often lead to C. difficile infection by 30 percent (this is 5 percent of overall antibiotic use) could lead to 26 percent fewer of these deadly diarrheal infections," said CDC.

In the face of these findings, CDC urged hospitals to implement "antibiotic stewardship" programs aimed at regulating how these medications are used through steps like improved education, tracking and reporting practices.

CDC also recommended that hospital patients ask their health care providers if tests will be done to ensure that the right antibiotic is being prescribed.

"Be sure everyone cleans their hands before touching you," said CDC. "If you have a catheter, ask each day if it is necessary."

"The CDC’s recent warning regarding antimicrobial stewardship is both timely and sobering," said E. Lee Carter, RPh, Clinical Pharmacy Specialist at the Department of Veterans Affairs in Prestonsburg, Kentucky. "Antibiotic resistance continues to concern infectious-disease specialists around the country. Resistance to E. Coli, Staphylococcus species and Pseudomonas continues to provide increasing challenges to clinicians."

According to Carter, "Pharmaceutical companies traditionally have not placed as much emphasis on research and development in the area of new antimicrobials, leaving newer agents to fight the diseases caused by these organisms lacking. Coupled with the pressure from patients placed on providers to prescribe antibiotics at nearly every visit, and a perfect storm of 'super-bug' resistance may be brewing in the near future. Many hospitals are already faced with challenging patient-care scenarios due to misuse and overprescribing of select antimicrobials within their respective institutions."

Carter concluded, "Prudent prescribing and use of our existing armament of available treatment options will be crucial in minimizing the impact of antibiotic resistance. Prescriber and patient education will be paramount in ensuring we have adequate coverage against these organisms for future generations."

In a press release from CDC, CDC Director Tom Frieden, MD, MPH, stressed the importance of these findings.

“Improving antibiotic prescribing can save today’s patients from deadly infections and protect lifesaving antibiotics for tomorrow’s patients,” said Dr. Frieden. “Health care facilities are an important part of the solution to drug resistance and every hospital in the country should have a strong antibiotic stewardship program.”

This report was published in the March issue of Vital Signs, a monthly report from CDC.

Review Date: 
March 6, 2014
Last Updated:
March 11, 2014