Antibiotic overuse: 1 in 3 antibiotics is unnecessary

The South ranks No. 1 in the nation for the number of antibiotic prescriptions, many of them unnecessary. The Vanderbilt Antimicrobial Stewardship Program aims to change that.

We all appreciate antibiotics. They quickly knock out bacterial infections, from the merely annoying to the potentially deadly: pneumonia, sepsis and meningitis. Most of us have taken antibiotics, and honestly, it’s hard to imagine life without them.

That’s all the more reason to safeguard them for future use — and why experts are raising awareness that antibiotic overuse is leading some bacteria to develop “antibiotic resistance,” meaning that the bacteria are harder to kill.

“Antibiotics helped us turn some of our deadliest, most devastating infections into stories in the history books,” said Dr. Sophie Katz, member of the Vanderbilt Antimicrobial Stewardship Program. “Now, because of their overuse, antibiotics are becoming less effective, and there’s a scary reality that they might not be effective 10-20 years from now.”

By the numbers: Antibiotic overuse and the cost

To understand why antibiotic resistance is so important and the dangers of taking too many antibiotics, let’s take a closer look at the numbers:

• The Centers for Disease Control estimates that 30% of outpatient-prescribed antibiotics are unnecessary.
• When you count total inappropriate antibiotic use, including incorrect dosing/duration, the number is closer to 50%, the CDC estimates.
• There are more than 2.8 million antibiotic-resistant infections in the U.S. annually, leading to more than 35,000 deaths, according to the CDC
• Antibiotics cause an estimated 56% of emergency room visits for bad drug reactions in children 5 or younger.
• Antibiotics cause up to 15% of estimated emergency room visits for bad drug reactions overall.
• In the U.S. in 2017, about 223,900 people were hospitalized because of C. diff (Clostridioides difficile, an antibiotic-resistant bacteria that can overwhelm the intestines after antibiotics have killed off the good bacteria in the gut), leading to at least 12,800 deaths, the CDC estimates.
• Tennessee is No. 7 for most antibiotic prescriptions per capita at 842 per 1,000 people and consistently ranks among the top 10 highest prescribing states.

A powerful partnership to correct antibiotic overuse

What can we do to ensure antibiotics continue to be there when we need them?

“We need to work together,” said Erin Neal, a pharmacist with the Vanderbilt Health Affiliated Network partnering with Katz to lead the antibiotic stewardship project for the network. “Change is difficult, so we all have a role to play: doctors, nurse practitioners, physician assistants, pharmacists — even patients.”

To help health-care providers be mindful of their habits around antibiotic prescriptions, the Vanderbilt team started tracking clinic-level prescription rates and reporting them quarterly to medical directors.

“Change is difficult, so we all have a role to play: doctors, nurse practitioners, physician assistants, pharmacists — even patients.”

“Sometimes, physicians don’t realize they are prescribing more antibiotics than their colleagues,” Katz said. “Seeing the numbers can have a big impact and help them improve.”

In addition, the Vanderbilt antibiotic stewardship team is working to ensure prescribers have easy access to antibiotic best practices from the computer system while they are in the clinic. So far, they have created guidelines for strep throat, sinusitis, urinary tract infections and chest colds, with more to come. These guidelines are also shared with prescribers across the Vanderbilt Health Affiliated Network.