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Inappropriate Use of Antibiotics in ERs Remains a Problem

Incorrect use for respiratory infections decreases in children, but not in adults (January 9)

An analysis of emergency room visits over a 10-year period finds that while inappropriate antibiotic use is decreasing in pediatric settings, it continues to remain a problem in adults, according to an article published ahead of print in Antimicrobial Agents and Chemotherapy.

In the study, the investigators analyzed data from the National Hospital Ambulatory Medical Care Survey for the years 2001–2010. During this period, acute respiratory tract infections accounted for 126 million visits to emergency departments in the U.S. In patients under the age of 19 years, the investigators found a decrease in the use of antibiotics for respiratory infections where they were not indicated. They saw no such reduction in adult patients.

“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,” the investigators write in 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.”

Complicating the picture, the investigators suggest that the lack of reduction in the use of antibiotics in these cases may reflect, among other things, the difficulty of making definitive diagnoses, and the fact that patients often expect to receive antibiotics and pressure clinicians for them.

Source: ASM; January 9, 2014.

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