Antibiotic resistance has been an issue for many years and multiple studies have shown that most cases of otitis media are viral.  Sinusitis has also been shown to rarely benefit from antibiotics.  This article examines the potential overprescription of antibiotics.  The CDC believes at least one in every three antibiotic prescription may be unnecessary.  This study examines the numbers of outpatient, oral antibiotic prescribing by age and diagnosis in the United States and the estimated portion of antibiotic use that may be overprescribed in adults and children.

The study published Tuesday in JAMA, was conducted by the Centers for Disease Control and Prevention using data from the 2010–11 National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey to determine the number of outpatient visits resulting in antibiotic prescriptions by age, region and diagnosis.The study found an estimated 154 million primary-care physician and emergency department visits each year resulted in the writing of an antibiotic prescription. Nearly half were for respiratory conditions for which antibiotics prove largely ineffective.

The findings mark the first detailed look at all antibiotic prescribing throughout the country. The goal is to identify areas where overprescribing is taking place in order to promote greater stewardship of such medications. Efforts to do so have become a major priority as public health officials try to combat the overuse of antibiotics that has driven the rise in antimicrobial-resistant infections, or “superbugs.”

The number of existing antibiotics that effectively treat such pathogens has been steadily declining over the past two decades. During this period, the pipeline to develop newer medications dwindled as drugmakers opted to focus on producing more profitable treatments.

“Antibiotics are lifesaving drugs, and if we continue down the road of inappropriate use we’ll lose the most powerful tool we have to fight life-threatening infections,” said CDC Director Dr. Tom Frieden in a written statement. “Losing these antibiotics would undermine our ability to treat patients with deadly infections, cancer, provide organ transplants, and save victims of burns and trauma.”

The highest rates of outpatient antibiotic prescriptions were found in Southern states, according to a separate report released Tuesday by Pew. The lowest rates were in Western states.

The CDC and Pew provided recommendations for outpatient health providers to improve their stewardship of antibiotics, which include employing such activities as waiting or delaying prescribing and talking to patients about the appropriate time to prescribe such medications.

Efforts to curb the unnecessary use of antibiotics spurred the White House last year to release its National Action Plan for Combating Antibiotic-Resistant Bacteria, which set a goal of reducing inappropriate outpatient antibiotic use by at least half by 2020. That would require a 15% reduction in antibiotic prescriptions over the next four years.

Source: JAMA Network | JAMA | Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011