BACKGROUND: While antibiotics are life-saving drugs, their use is not without risk, including adverse events and antibiotic resistance. The majority of US antibiotic prescriptions are prescribed in outpatient settings, making outpatient antibiotic prescribing an important antibiotic stewardship target. The primary objective of this study was to describe trends in US outpatient oral antibiotic prescriptions from 2011-2016. METHODS: We estimated annual oral antibiotic prescription rates using national prescription dispensing count data from IQVIA Xponent, divided by census estimates for 2011-2016. We calculated the ratio of broad- to narrow-spectrum prescriptions by dividing broad-spectrum prescription rates by narrow-spectrum prescription rates. We used Poisson models to estimate prevalence rate ratios, comparing 2011 and 2016 antibiotic prescription rates, and linear models to evaluate temporal trends throughout the study period. RESULTS: Oral antibiotic prescription rates decreased 5%, from 877 prescriptions per 1000 persons in 2011 to 836 per 1000 persons in 2016. During this period, rates of prescriptions dispensed to children decreased 13%, while adult rates increased 2%. The ratio of broad- to narrow-spectrum antibiotics decreased from 1.62 in 2011 to 1.49 in 2016, driven by decreases in macrolides and fluoroquinolones. The proportion of prescriptions written by nurse practitioners and physician assistants increased during the study period; in 2016, these providers prescribed over one-quarter of all antibiotic prescriptions. CONCLUSIONS: Outpatient antibiotic prescription rates, especially of broad-spectrum agents, have decreased in recent years. Clinicians who prescribe to adults, including nurse practitioners and physician assistants, are important targets for antibiotic stewardship. Published by Oxford University Press for the Infectious Diseases Society of America 2019.
BACKGROUND: While antibiotics are life-saving drugs, their use is not without risk, including adverse events and antibiotic resistance. The majority of US antibiotic prescriptions are prescribed in outpatient settings, making outpatient antibiotic prescribing an important antibiotic stewardship target. The primary objective of this study was to describe trends in US outpatient oral antibiotic prescriptions from 2011-2016. METHODS: We estimated annual oral antibiotic prescription rates using national prescription dispensing count data from IQVIA Xponent, divided by census estimates for 2011-2016. We calculated the ratio of broad- to narrow-spectrum prescriptions by dividing broad-spectrum prescription rates by narrow-spectrum prescription rates. We used Poisson models to estimate prevalence rate ratios, comparing 2011 and 2016 antibiotic prescription rates, and linear models to evaluate temporal trends throughout the study period. RESULTS: Oral antibiotic prescription rates decreased 5%, from 877 prescriptions per 1000 persons in 2011 to 836 per 1000 persons in 2016. During this period, rates of prescriptions dispensed to children decreased 13%, while adult rates increased 2%. The ratio of broad- to narrow-spectrum antibiotics decreased from 1.62 in 2011 to 1.49 in 2016, driven by decreases in macrolides and fluoroquinolones. The proportion of prescriptions written by nurse practitioners and physician assistants increased during the study period; in 2016, these providers prescribed over one-quarter of all antibiotic prescriptions. CONCLUSIONS:Outpatient antibiotic prescription rates, especially of broad-spectrum agents, have decreased in recent years. Clinicians who prescribe to adults, including nurse practitioners and physician assistants, are important targets for antibiotic stewardship. Published by Oxford University Press for the Infectious Diseases Society of America 2019.
Authors: Anthony W Chow; Michael S Benninger; Itzhak Brook; Jan L Brozek; Ellie J C Goldstein; Lauri A Hicks; George A Pankey; Mitchel Seleznick; Gregory Volturo; Ellen R Wald; Thomas M File Journal: Clin Infect Dis Date: 2012-03-20 Impact factor: 9.079
Authors: Lauri A Hicks; Monina G Bartoces; Rebecca M Roberts; Katie J Suda; Robert J Hunkler; Thomas H Taylor; Stephanie J Schrag Journal: Clin Infect Dis Date: 2015-03-05 Impact factor: 9.079
Authors: Ellen R Wald; Kimberly E Applegate; Clay Bordley; David H Darrow; Mary P Glode; S Michael Marcy; Carrie E Nelson; Richard M Rosenfeld; Nader Shaikh; Michael J Smith; Paul V Williams; Stuart T Weinberg Journal: Pediatrics Date: 2013-07 Impact factor: 7.124
Authors: Jeffrey S Gerber; Rachael K Ross; Matthew Bryan; A Russell Localio; Julia E Szymczak; Richard Wasserman; Darlene Barkman; Folasade Odeniyi; Kathryn Conaboy; Louis Bell; Theoklis E Zaoutis; Alexander G Fiks Journal: JAMA Date: 2017-12-19 Impact factor: 56.272
Authors: Katherine E Fleming-Dutra; Alicia Demirjian; Monina Bartoces; Rebecca M Roberts; Thomas H Taylor; Lauri A Hicks Journal: Pediatr Infect Dis J Date: 2018-01 Impact factor: 2.129
Authors: Kate E Dingle; Xavier Didelot; T Phuong Quan; David W Eyre; Nicole Stoesser; Tanya Golubchik; Rosalind M Harding; Daniel J Wilson; David Griffiths; Alison Vaughan; John M Finney; David H Wyllie; Sarah J Oakley; Warren N Fawley; Jane Freeman; Kirsti Morris; Jessica Martin; Philip Howard; Sherwood Gorbach; Ellie J C Goldstein; Diane M Citron; Susan Hopkins; Russell Hope; Alan P Johnson; Mark H Wilcox; Timothy E A Peto; A Sarah Walker; Derrick W Crook Journal: Lancet Infect Dis Date: 2017-01-25 Impact factor: 71.421
Authors: Danielle L Palms; Lauri A Hicks; Monina Bartoces; Adam L Hersh; Rachel Zetts; David Y Hyun; Katherine E Fleming-Dutra Journal: Antimicrob Agents Chemother Date: 2019-10-22 Impact factor: 5.191
Authors: Randall J Olsen; Luchang Zhu; Regan E Mangham; Ahmad Faili; Samer Kayal; Stephen B Beres; James M Musser Journal: Am J Pathol Date: 2022-07-15 Impact factor: 5.770
Authors: Kaitlin Benedict; Sharon V Tsay; Monina G Bartoces; Snigdha Vallabhaneni; Brendan R Jackson; Lauri A Hicks Journal: Antimicrob Steward Healthc Epidemiol Date: 2022-12-22
Authors: Alice Y Guh; Yi Mu; Lisa G Winston; Helen Johnston; Danyel Olson; Monica M Farley; Lucy E Wilson; Stacy M Holzbauer; Erin C Phipps; Ghinwa K Dumyati; Zintars G Beldavs; Marion A Kainer; Maria Karlsson; Dale N Gerding; L Clifford McDonald Journal: N Engl J Med Date: 2020-04-02 Impact factor: 91.245
Authors: Michael S Pulia; Sara C Keller; Christopher J Crnich; Robin L P Jump; Thomas T Yoshikawa Journal: J Am Geriatr Soc Date: 2019-11-21 Impact factor: 5.562
Authors: Milner B Staub; Youssoufou Ouedraogo; Christopher D Evans; Sophie E Katz; Pamela P Talley; Marion A Kainer; George E Nelson Journal: Infect Control Hosp Epidemiol Date: 2020-02 Impact factor: 3.254
Authors: Molly R Petersen; Sara E Cosgrove; Thomas C Quinn; Eshan U Patel; M Kate Grabowski; Aaron A R Tobian Journal: Open Forum Infect Dis Date: 2021-05-13 Impact factor: 3.835