February 25, 2019
2 min read

Analysis shows ‘meaningful’ decline in outpatient antibiotics in New England

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An examination of outpatient antibiotics dispensed within a single commercial health insurance plan in New England showed a “meaningful” decrease in the proportion of patients who filled prescriptions for antibiotics between 2000 and 2016, researchers reported.

Inappropriate antibiotic prescribing is a widespread issue and is thought to be a driver of antimicrobial resistance, according to experts. Antibiotics are most common in the outpatient setting, but many interventions and antimicrobial stewardship efforts have been developed to limit their use.

For their study, Noelle M. Cocoros, DSc, MPH, an epidemiologist and research associate in the department of population medicine at Harvard Medical School and Harvard Pilgrim Health Care Institute, and colleagues aimed to determine the impact of these interventions and examine trends in outpatient antibiotic use.

The study was conducted within a single commercial health insurance plan in New England that covers approximately 970,000 members. Cocoros and colleagues calculated the proportion of members dispensed antibiotic prescriptions per year and reviewed the claims data by demographic, including age, sex, race, Hispanic ethnicity, and selected comorbidities.

Infographic about outpatient antibiotics 

Between 2000 and 2016, they observed a decrease from 33.3% to 25.9% in the proportion of members dispensed antibiotics. A consistent effect was also observed when the researchers assessed the proportion of members receiving antibiotics by demographic.

Additionally, the proportion of members who were dispensed two or more antibiotic prescriptions decreased from 15.4% in 2000 to 10.9% in 2016, Cocoros and colleagues reported. Children aged 0 to 4 years demonstrated the highest utilization of antibiotics, with antibiotics being dispensed for 31.8% of them in 2016, the researchers said. Similarly, 31.6% of adults aged 60 to 64 years filled prescriptions in 2016.

Cocoros and colleagues said that antibiotics were more commonly dispensed to women and patients with comorbidities.

“Over a 17-year period, we observed a meaningful, steady decline in the annual fraction of patients receiving antibiotics within a single commercial health plan,” Cocoros told Infectious Disease News. “These results, from the outpatient setting, were observed across age group, sex, race, Hispanic ethnicity, and comorbidities in this New England-based study. The long study period enabled us to see this trend over time.”

“Other long-term studies are certainly necessary to see whether our findings are observed elsewhere,” Cocoros concluded. “It will be important to further explore trends among subsets of patients, perhaps by more specifically examining comorbidities. Trends may vary by geographic region as well.” – by Marley Ghizzone

Disclosures: The authors report no relevant financial disclosures.