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Unnecessary Antibiotic Prescribing Can Result in Costly Adverse Effects

JUN 23, 2017 | KRISTI ROSA
Antibiotic resistance is a growing public health concern. In fact, the Centers for Disease Control and Prevention (CDC) estimate that at least 2 million Americans develop infections due to pathogens with developed resistance to available drugs, which results in a staggering 23,000 deaths each year. Although antibiotics have life-saving potential, when prescribed unnecessarily, they can do more harm than good.

A study coming in from Johns Hopkins found that not only does 1 in 5 adults suffer from adverse effects due to the antibiotics they are prescribed, but about a fifth of those effects occurred in patients who should not have received antibiotics in the first place.

The study, published in JAMA Internal Medicine, contributes to the wealth of evidence that “antibiotics are not benign,” according to a recent press release.

“Too often, clinicians prescribe antibiotics even if they have a low suspicion for a bacterial infection, thinking that even if antibiotics may not be necessary, they are probably not harmful. But that is not always the case.” Pranita Tamma, MD, MHS, assistant professor of pediatrics and director of the Pediatric Antimicrobial Stewardship Program at The Johns Hopkins Hospital, explained in the press release.

According to the press release, oftentimes, healthcare practitioners are not weighing the risks and benefits of the antibiotics before they prescribe them to their patients. In a recent interview, Lauri A. Hicks, DO, Office of Antibiotic Stewardship, Centers for Disease Control and Prevention, delved deeper into the risks and benefits of prescribing. She said, “For many, many years, we’ve thought of antibiotics as the quick-fix to, pretty much, any infection. What we’ve learned over, over the years, is that there are actual severe consequences associated with treating antibiotics without respect.” She continued, “We really need to be taking antibiotic treatment more seriously. When we talk to our patients about antibiotics we really need to be communicating about both the risks and benefits.”

In the press release, Dr. Tamma stressed that every time healthcare practitioners want to prescribe an antibiotic, they should reflect on if the patient actually needs it. If they do, and a patient ends up experiencing antibiotic-associated adverse effects, she says, “that is, of course, unfortunate, we should be able to take comfort in knowing that at least the antibiotic was truly necessary.”

In the study, the researchers took a closer look at medical records of 1,488 adults who had been admitted to the Johns Hopkins Hospital between September 2013 and June 2014. Although the patients’ reasons for admittance were diverse, all records included in the study belonged to patients who had received “at least 24 hours of antibiotic treatment.”

The researchers sought to “determine the likelihood of an adverse reaction to antibiotics and to identify how many adverse reactions could be avoided by eliminating unnecessary antibiotic use.” Therefore, they kept tabs on patients for 30 days after they had been discharged from the hospital.

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