Antibiotics are Overprescribed in the U.S.

antiobiotic poll

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There is no doubt that antibiotics save lives and stop infections. So why has the use of these drugs been a trending topic for debate?

According to the CDC, “…poor prescribing practices put hospital patients at risk for preventable allergic reactions, super-resistant infections, and deadly diarrhea caused by Clostridium difficile.  These practices also drive antibiotic resistance, further endangering the future of these miracle drugs and the patients who need them.”

We polled Sermo physicians about the practice of prescribing antibiotics in the U.S.  Of the 2,459 physicians that answered, an overwhelming 92 percent believed antibiotics were overprescribed. This left only seven percent saying they were prescribed appropriately, and one percent saying they were under-prescribed.

The staggering reaction to our poll resulted in some followup questions:

1)  Why are antibiotics over-prescribed?  Is it because of patient demand? Do physicians need more education?  Is the problem with other prescribing HCPs who need education?

2)  How do we “right-size” antibiotic prescriptions? What criteria should be followed to give just enough?

After a robust conversation, the most common theme addressing the over-prescription trend was due to patient demand. One doctor wrote, “It’s the path of least resistance and sadly in the era of health care now being a customer service industry, patient satisfaction trumps evidence based medicine. A patient going into the office with the sniffles wants something tangible in hand to “fix their problem” not an explanation why nothing is needed and leave the visit, in their mind, empty handed.”

Another doctor compared prescribing to the McDonald’s view stating, “Most patients have a McDonald’s approach to antibiotics and other medical treatments. They want it their way and fast. In the past, they went to their health care provider for the providers knowledge and expertise. They did not come for simple self-resolving problems and they respected the doctor’s opinion. Now the McDonald’s mentality is to demand expensive tests or unnecessary meds.”

As a society of quick fixes and fast solutions, this conclusion does not come as a surprise.  Support for this view comes from an article presented by Medscape discussing a study which found that “…out of 3402 adults presenting to primary care with cough, roughly 45% “expected” antibiotics, 41% “hoped for” antibiotics, and 10% “asked for” antibiotics.”

So how can this issue be solved?

A family practice MD expressed her opinion of further education. “All of us need to do a better job and only prescribe antibiotics when it is clear that we believe there is a bacterial infection that we are trying to cure. Otherwise, antibiotics will no longer work.  I think doctors don’t need more education. The public does. We need to learn how to say no. The public needs to learn the difference between infections that are viral and bacterial and that antibiotics don’t cure all infections.”

What do you believe is the reason for over-prescribing? Do you have an idea of what can aid in decreasing this practice? If you are an MD or D.O. we will be continuing this conversation within Sermo.

 

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