Antibiotic Use Declines Overall, While Use of Broad-Spectrum Increases

Antibiotic Use Declines Overall, While Use of Broad-Spectrum Increases

Physicians are prescribing fewer antibiotics for acute respiratory tract infections (ARTIs), but if an antibiotic is used, it is more likely to be a broad-spectrum drug. Using data from 1995 to 2006, antibiotic trends were reviewed from a national database for ARTIs, which included otitis media (OM). Children younger than age 5 were seen less frequently for ARTI than in the past, and they were less likely to be prescribed an antibiotic (36% reduction; 95% confidence interval [CI], 26%-45%). Among children age 5 or older, ARTI visit rates remained stable but antibiotic prescription rates decreased by 18% (95% CI, 6%-29%). Excluding otitis media, antibiotic prescription rates decreased by 41% among all age groups. Prescription rates for a penicillin, cephalosporins, and sulfonamide/tetracycline decreased while the rate of prescriptions for azithromycin increased, making it the most commonly prescribed macrolide for ARTI and OM. Among adults, quinolone prescriptions also increased. The authors conclude that overall antibiotic prescription rates for ARTI decreased in the last 10 years; however, prescription rates for broad-spectrum antibiotics increased significantly (Grijalva CG, et al. JAMA 2009;302:758-766). This study points out the success of multiple campaigns to decrease antibiotic use for ARTIs, which are primarily caused by viruses. However the increasing use of broad-spectrum antibiotics is concerning.