The rate at which antibiotic prescriptions were filled declined 9% from 2010 to 2016, according to the Blue Cross Blue Shield Association (BCBSA), indicating that public health campaigns aimed at curbing overuse and halting the growth of antimicrobial resistance are taking hold.
Pediatricians appear to lead the way in reducing antibiotic use, as prescriptions filled for children dropped 16% and those for infants fell 22%. Also, BCBS members filled 13% fewer prescriptions for broad spectrum antibiotics, which are used to treat a wide range of bacteria and are most likely to trigger the development of antibiotic-resistant strains.
The report, “Antibiotic Prescription Fill Rates Declining in the U.S.,” represents a comprehensive study of outpatient medical claims from commercially insured BCBS members who filled antibiotic prescriptions over a 7-year period. The study also found that:
- There is wide regional variation in antibiotic use with Mississippi, Alabama, and Arkansas showing the highest rates of prescriptions filled. The rate at which BCBS members filled antibiotic prescriptions in these three states was nearly 3 times greater than those in the lowest states of Hawaii, Oregon, and Montana.
- Those in rural areas filled prescriptions at a rate 16% higher than BCBS members in urban areas.
- In 21% of cases, patients were prescribed antibiotics for conditions for which they were not likely to be an effective treatment. Broad-spectrum antibiotics were prescribed in 75% of these questionable cases.
- Prescriptions for reserved antibiotics spiked 30% and are the only category of antibiotic showing an upswing in use. They are used infrequently and typically are meant as a treatment of last resort to fight bacteria that have developed resistance to other antibiotics.
“Public health efforts to increase the awareness of excessive antibiotic use and the threat posed by antibiotic-resistant bacteria appear to be achieving measurable results,” said Trent Haywood, MD, senior vice president and chief medical officer of the BCBSA.
“This report demonstrates that antibiotic use among commercially insured people in the United States is declining, and it is largely due to the reduction in the use of broad-spectrum antibiotics,” said Haywood. “Unfortunately, the data also show continued high use of broad-spectrum antibiotics for conditions where they have limited effectiveness, indicating there are further improvements to be made.”
“We are pleased to see improvements in prescribing for children, but we recognize that there are still opportunities to improve antibiotic use in all ages,” said Denise Cardo, MD, director of the Centers for Disease Control and Prevention (CDC) Division of Healthcare Quality Promotion. “CDC is applying all that we have learned from successes in children to inform best practices for prescribing in adults. We applaud BCBSA for making their data available to inform action.”
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