Trends in outpatient antibiotic use and prescribing practice among older adults

Harvard-affiliated researchers undertook an observational study for the purpose of tracking trends in outpatient antibiotic prescribing and usage among older U.S. adults. They used 2011–15 administrative claims data from the federal Medicare program to estimate the number of antibiotic claims per 1,000 beneficiaries per year.

Harvard-affiliated researchers undertook an observational study for the purpose of tracking trends in outpatient antibiotic prescribing and usage among older U.S. adults. They used 2011–15 administrative claims data from the federal Medicare program to estimate the number of antibiotic claims per 1,000 beneficiaries per year. The sample population included 4.5 million Medicare patients aged 65 years and older who submitted 19.5 million antibiotic claims during the study period. For most of the 5 years in question, overall antibiotic prescribing and potentially inappropriate prescribing held steady or dipped a bit. Divergent changes in use were documented, however, for various drugs. Claims tied to azithromycin, for example, fell 18.5%, while claims for levofloxacin surged 27.7%. The trends in drug use across indications were stronger than trends in use for individual indications, which the investigators interpreted to mean that guidelines and fears about antibiotic resistance were not the primary reason for changes in antibiotic use. Rather, they were the byproduct of shifting use between antibiotics. Robust policy changes and novel approaches to stewardship are the key to significantly improving antibiotic prescribing practice, they conclude.