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# Many Antibiotic Scripts ‘Likely Inappropriate’: Study
- URL: https://www.fdaweb.com/many-antibiotic-scripts-likely-inappropriate-study/
- Published: 2016-05-04T12:00:00.000Z
- Updated: 2026-09-14T20:59:20.000Z
- Author: David McFarland
- Tags: Drugs, #legacy-id-D5135564

A study by the Centers for Disease Control and Pew Charitable Trusts that involved researchers across the country says that only about 70% of antibiotic prescriptions in the U.S. in 2010-2011 were appropriate, supporting the need for establishing a goal for outpatient antibiotic stewardship. The story was [published](http://jama.jamanetwork.com/article.aspx?articleid=2518263&ref=fdaweb.com) in the *Journal of the American Medical Association*. It says that the study was needed because the National Action Plan for Combating Antibiotic-Resistant Bacteria set a goal of reducing inappropriate outpatient antibiotic use by 50% by 2020, but the baseline extent of inappropriate outpatient antibiotic use is unknown.

 “Reducing inappropriate use is essential to reduce both antibiotic resistance and adverse events,” the report says. “However, the fraction of antibiotic use that is inappropriate and amenable to reduction is unknown.”

The researchers found an overall estimated annual rate of 506 antibiotic prescriptions per 1,000 U.S. population in 2010-2011\. In the U.S., an estimated 154 million prescriptions for antibiotics were written in ambulatory care settings annually in that time period. They say that half of antibiotic prescriptions for acute respiratory conditions may have been unnecessary, representing 34 million antibiotic prescriptions annually. With an estimated 30% of outpatient oral antibiotic prescriptions potentially inappropriate, the report declares, a 15% reduction in overall antibiotic use would be necessary to meet the White House National Action Plan for Combating Antibiotic-Resistant Bacteria goal.

An accompanying [editorial](http://jama.jamanetwork.com/article.aspx?articleid=2518237&ref=fdaweb.com) says that the study is a good and needed first step and that follow-up studies should include an assessment of the specific antibiotic regimens prescribed. “It would be informative to assess what classes of antibiotics are overused and the proportion of first-line recommended agents prescribed for various indications,” it says.

“Now that baseline estimates about outpatient antibiotic prescribing have been determined,” the editorial concludes, “future work needs to focus on interventions targeting both clinicians and patients to help reach the national goal. It will be critical to continue to evaluate progress in improving antibiotic use in conjunction with widespread adoption of antibiotic stewardship activities in the outpatient setting.”

An associated Pew [report](http://www.pewtrusts.org/en/research-and-analysis/reports/2016/05/antibiotic-use-in-outpatient-settings?ref=fdaweb.com) says that antibiotics should be prescribed only when a bacterial infection is known or suspected. An expert panel convened by Pew and the CDC suggested these roles that stakeholders could play in reducing inappropriate antibiotic use: 

- individual outpatient healthcare providers can evaluate their own prescribing habits and implement stewardship activities in their practices;
- health systems can provide expertise and resources to offices in their networks to aid in stewardship implementation;
- health plans can assist in data collection and analysis by evaluating the antibiotic prescribing habits of their providers and providing feedback highlighting potential areas for improvement;
- state and local health agencies can help provide outpatient facilities with information on best practices for implementing antibiotic stewardship programs, and help develop regional partnerships between various healthcare stakeholders;
- federal agencies can track antibiotic prescribing at the national level;
- organizations that develop standards to assess the quality of healthcare services can develop metrics to assess the antibiotic prescribing habits of healthcare providers; and
- healthcare professional societies can provide expert guidance to their members on appropriate antibiotic prescribing and incorporating diagnostics to aid in prescribing decision-making.