Antibiotics overused for adult emergency-room patients

An analysis of emergency department (ED) visits over a 10-year period found that while inappropriate antibiotic use is decreasing in pediatric settings, it continues to remain a problem in adults, according to a study published ahead of print in Antimicrobial Agents and Chemotherapy.

Antibiotic use for acute respiratory tract infections (ARTIs) such as rhinitis, sinusitis, and bronchitis, which are often caused by viruses and do not require antibiotics, are still commonly given to adults who visit EDs for care, said John W. Baddley, MD, MSPH, department of medicine, division of infectious diseases, University of Alabama at Birmingham.

“While ED antibiotic use for ARTIs decreased among children over the past decade, there was no decrease in use seen in adults,” Baddley said. “The widespread use of antibiotics to treat minor ARTIs may lead to increased bacterial antibiotic resistance. Other consequences include antibiotic-associated diarrhea, allergic reactions, and increased cost of care.”

Baddley and colleagues used data from the National Hospital Ambulatory Medical Care Survey, which provides national snapshots of care provided by U.S. EDs, and studied the 10-year period from 2001 to 2010.

“We divided ARTIs into those for which antibiotics are typically warranted and those for which they are not,” Baddley said. “We analyzed the data to determine age-specific antibiotic utilization rates over the study period.”

During this time in the United States, ARTIs accounted for 126 million visits to EDs. In patients under 19 years of age they saw a decrease in the utilization of antibiotics for respiratory infections where they are not indicated. No such reduction was seen in adult patients.

“Our study highlights the magnitude of inappropriate antibiotic use in U.S. EDs,” Baddley said. “Better antibiotic stewardship in the ED setting is needed to prevent bacterial antibiotic resistance that may threaten our ability to treat infections.”