The authors of the study found that overall, 55.1% of patients discharged received at least one dose of an antibiotic during their hospital visit. In that same time period, the overall rate of antibiotic use was 755 days per 1,000 patient days. The highest proportion of discharges in which an antibiotic was given during the hospital visit was for first- and second-generation cephalosporins, fluoroquinolones, and third- and fourth-generation cephalosporins. Overall usage declined for aminoglycosides, first and second generation cephalosporins, fluoroquinolones, sulfa, and metronidazole, while the use of cacrolides, third- and fourth-generation cephalosporins, glycopeptides, beta-lactam/beta-lactamase inhibitor combinations, carbapenems, and tetracyclines increased during this time.
Along with the much hoped for drop in antibiotic use that the study authors did not observe, they noted a concerning rise in the use of broad-spectrum antibiotics once reserved for a smaller number of dangerous infections. The findings highlight the work still ahead for US hospitals tasked with reducing their use of antibiotics.
“We need to improve the systems in hospitals that will support optimal prescribing through good antibiotic stewardship programs,” says James Baggs, PhD, one of the study’s authors. “We need to improve education for all healthcare providers on how to better our antibiotic use. We need to improve the availability and use of better and faster tests to diagnose infections. And we need to improve the availability and use of data on antibiotic use in all hospitals.”
“We know that providers want more information on antibiotic resistance trends that might impact which antibiotics they choose for their patients,” notes Dr. Baggs. “They also want more education, starting at earlier stages of their training, like medical school, on how to optimize their selection of antibiotics. Patients also want more information on steps they can take. We encourage patients to talk to their providers about any antibiotics they are prescribed so that they know the reason they are taking the antibiotic, exactly how and how long to take it and what side effects to watch out for.
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