HealthDay News — A considerable proportion of antibiotics are prescribed without a documented indication, according to a study published online Dec. 11 in The BMJ.

Michael J. Ray, M.P.H., from the Oregon Health & Science University-Portland State University School of Public Health, and colleagues conducted a cross-sectional study involving 28,332 sample visits representing 990.8 million ambulatory care visits nationwide to examine the frequency with which antibiotics are prescribed in the absence of a documented indication in the ambulatory care setting.

The researchers found that of the 990.8 million estimated ambulatory care visits in 2015, antibiotics were prescribed during 13.2 percent. Overall, 57 percent of the 130.5 million prescriptions were for appropriate indications, 25 percent were for inappropriate indications, and 18 percent had no documented indication, corresponding to an estimated 24 million prescriptions with no documented indication. Significant, positive associations were seen for being an adult male, spending more time with the provider, and seeing a nonprimary care specialist with antibiotic prescribing without an indication. The antibiotic classes most likely to be prescribed without documentation were sulfonamides and urinary anti-infective agents.

“Antibiotic prescribing in the absence of a documented indication may severely bias national estimates of appropriate antibiotic use in this setting and misinform antimicrobial stewardship efforts,” the authors write.


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One author disclosed financial ties to the pharmaceutical industry.

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