HealthDay News — Less than half of all outpatient antibiotic prescription fills by privately insured nonelderly adults and children in the United States are appropriate or potentially appropriate, according to a study published online Jan. 16 in The BMJ.

Kao-Ping Chua, MD, PhD, from the University of Michigan Medical School in Ann Arbor, and colleagues conducted a cross-sectional study involving 19.2 million enrollees aged 0 to 64 years to assess the appropriateness of outpatient antibiotic prescribing for privately insured children and nonelderly adults. A classification scheme was developed to determine whether the International Classification of Diseases-clinical modification-10th revision diagnosis codes always, sometimes, or never justified antibiotics. The cohort of 19,203,264 individuals included 14,571,944 adults with a total of 15,455,834 outpatient antibiotic prescription fills for the cohort.

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The researchers found that the most common antibiotics prescribed were azithromycin, amoxicillin, and amoxicillin-clavulanate (19, 18.2, and 11.6 %, respectively). Overall, 12.8 and 35.5 % of antibiotic fills were appropriate and potentially appropriate, respectively; 23.2 % were inappropriate; and 28.5 % were not associated with a recent diagnosis code. Of the inappropriate fills, 70.7, 6.2, and 4.7 % were written in office-based settings, urgent care centers, and emergency departments, respectively. In 2016, 14.1 % of the enrollees filled at least one inappropriate antibiotic prescription, including 10.6 and 15.2 % of children and adults, respectively.

“Our results show the scale of inappropriate antibiotic prescribing at both the prescription and population levels,” the authors write.

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