Infectious Disease

Study shows a decrease in unnecessary antibiotic prescriptions in VA hospitals

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Appaneal H, et al. National Trends in Ambulatory Antibiotic Use in the United States (USA): 2011 to 2018. Presented at: ECCMID 2021; 9-12 July 2021 (virtual meeting).

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Appaneal does not report any relevant financial information. Please refer to the study for all relevant financial information from the other authors.

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Data from Veterans Health Administration pharmacies showed that outpatient antibiotic prescriptions fell nearly 4% annually from 2011 to 2018, researchers reported at the ECCMID virtual meeting.

The researchers said the downward trend could be due to antibiotic stewardship programs.

Antibiotic Prescriptions Infographic

Source: Appaneal H, et al. National Trends in Ambulatory Antibiotic Use in the United States (USA): 2011 to 2018. Presented at: ECCMID 2021; 9-12 July 2021 (virtual meeting).

“VA clinicians should be congratulated on their efforts to reduce the unnecessary use of antibiotics in VA outpatient facilities such as VA outpatient clinics and outpatient clinics.” Haley Appaneal, PharmD, PhD, a researcher at Providence VA Medical Center in Rhode Island, said Healio.

“The largest reduction in ambulatory antibiotic use we observed was with ciprofloxacin, which declined 12% per year from 2011 to 2018,” said Appaneal. “These findings may be related to the national move away from using fluoroquinolones such as ciprofloxacin, the most widely used fluoroquinolone.”

Haley Appaneal

Appaneal and colleagues examined data from VA pharmacy datasets – which spanned approximately 24 million antibiotic therapy days and more than 76 million patient bed days – to decipher trends in antibiotic prescribing between 2011 and 2018. They estimated the annual number of days of therapy (DOT.). ) per 100 outpatient visits for all antibiotics plus the five most commonly prescribed antibiotics – azithromycin, amoxicillin / clavulanate, doxycycline, ciprofloxacin, and sulfamethoxazole / trimethoprim.

From 2011 to 2018, antibiotic prescriptions fell from DOT 39.6 per 100 visits to DOT 29.4 per 100 visits – an average decrease of 3.9% annually. They saw the biggest drop in the prescription of ciprofloxacin, falling an average of 12.6% per year.

Appaneal said the limitations of the study include the inability to accommodate antibiotic prescriptions outside the VA system and incomplete data on antibiotic use in certain outpatient settings.

“The generalizability of the results to the general US population is limited,” said Appaneal. “Although the VA is a predominantly older white male population, other health systems with strong antibiotic stewardship programs in the United States may be seeing similar trends.”

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European Congress for Clinical Microbiology and Infectious Diseases

European Congress for Clinical Microbiology and Infectious Diseases

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