Researchers from the University of Alabama at Birmingham have found that between 2001 and 2010, inappropriate antibiotic use in the ER decreased in pediatric settings, but continues to be a problem for adults. The findings were published ahead of print in Antimicrobial Agents and Chemotherapy.
Information for the research was gathered from the National Hospital Ambulatory Medical Care Survey for the years 2001 through 2010. After reviewing the data, researchers found that during this time, acute respiratory tract infections accounted for 126 million visits to emergency departments in the United States. In patients under the age of 19, researchers saw a decrease in the prescription of antibiotics for respiratory infections in instances where they were not needed. However, they saw no such reduction in adult patients.
“That’s very unfortunate because the ER sees so many patients for primary care visits—especially among those who are uninsured or insured by Medicare,” said John Baddley, co-author of the study. “A major reduction in the use of inappropriate antibiotics in the ER could have a big benefit just due to the large number of patients seen.”
According to the study, acute respiratory tract infections, including rhinitis, sinusitis, and bronchitis, account for nearly one-tenth of ambulatory care visits in the United States. While viruses cause many of these infections, clinicians still prescribe antibiotics. Researchers are concerned because viruses are impervious to antibiotics, and inappropriate antibiotic use can lead to the development of antibiotic resistance.
“The observed lack of change in antibiotic utilization for adult acute respiratory tract infection patients, especially those with infections where antibiotics are not indicated, is concerning,” noted researchers with the study. “This may indicate that efforts to curtail inappropriate antibiotic use have not been effective, or have not yet been implemented for this subset of patients.”
What’s more, the study investigators suggest the use of antibiotics in these cases may reflect the difficulty emergency room personnel have with trying to make a definitive diagnosis, and the fact that patients frequently expect to receive an antibiotic and pressure clinicians for them.