Poor prescription practices mean that doctors in certain hospitals prescribed more than three times the amount of antibiotics that other hospitals did, though the level of care was comparable. When overprescribed, the body can build immunity to the drugs, meaning that taking them does little to fight infection. Similarly, incorrectly prescribed antibiotics lead to higher instances of allergic reactions and diarrhea. In addition, more than half of America's hospitalized patients receive antibiotics, says a report from the Centers of Disease Control and Prevention (CDC), emphasizing the need for correct prescription procedures.
Vital Signs, the CDC's monthly report on public health issues, pointed to the need for an antibiotic stewardship program to enhance consistency between medical facilities. As a result, a checklist of seven core principles was drawn up to encourage best practice in prescribing antibiotics, with an accompanying implementation document that explores each element in greater detail.
Among the conditions that physicians wrote the most prescriptions for were urinary tract infections, lung infections, and infections cause by the drug-resistant Staphylococcus bacteria, including MRSA. In several cases, patients were found to have been misdiagnosed and administered with either the wrong antibiotics or too a high a volume of them. The overuse of vancomycin for MRSA, in particular, was found to be rife, with 36 percent of patients unnecessarily prescribed the drug. In one-fifth of said cases, patients were found not to have MRSA, indicating that closer monitoring of their conditions was required. "We're saying reassess. At 48 hours maybe what you thought was MRSA turned out to be something else. If it's not [MRSA], maybe it is time to stop the vancomycin," said Arjun Srinivasan, the CDC's associate director for health care-associated infection prevention programs.
Vital Signs' concentration on antibiotic prescription was a result of two main catalysts: the Antibiotic Resistance Threats to the United States, 2013 report and the 2013 Get Smart about Antibiotics Week. Further, the Transatlantic Taskforce on Antimicrobial Resistance 2013 is set to release a report later this year.
"Improving antibiotic prescribing can save today's patients from deadly infections and protect lifesaving antibiotics for tomorrow's patients," said CDC Director Tom Frieden, M.D., M.P.H. "Health care facilities are an important part of the solution to drug resistance and every hospital in the country should have a strong antibiotic stewardship program."