Urgent cares prescribing far too many antibiotics
Unnecessary drugs could lead to severe side effects.
Nearly half of patients who go to urgent care clinics seeking treatment for a flu, cold or other conditions that don’t require antibiotics received a prescription for one anyway. That’s three times as often as antibiotics are prescribed to patients with the same illnesses in traditional doctors’ offices, according to a study published Monday.
Patients who get unnecessary antibiotics are at risk for severe side effects, even with just one dose of the medicine, doctors say. Inappropriate use of these lifesaving drugs also puts everyone else at risk because overuse accelerates the emergence of resistant bacteria, or “superbugs,” that can’t be stopped with drugs.
An analysis published in the journal JAMA Internal Medicine is the first study of antibiotic prescribing in the growing number of urgent care centers and retail health clinics, which together serve millions of patients at thousands of locations across the United States each year. Retail clinics are embedded in grocery stores, big-box stores and pharmacy chains. Urgent care clinics typically treat more pressing injuries or illnesses that don’t require an emergency room visit.
Antibiotic overuse is an enormous and growing problem around the world. If left unchecked, a United Kingdom report has forecast, antibiotic-resistant bacteria could result in 10 million deaths each year by 2050 more than the number of people killed by cancer - at a cost of $100 trillion to the global economy.
In the U.S., nearly onethird of antibiotics — or about 47 million prescriptions dispensed every year — in doctor’s offices, emergency rooms and hospital-based clinics are not needed and not effective, according to a 2016 study by the Centers for Disease Control and Prevention and the Pew Charitable Trust, the first to quantify the depth of the U.S. problem.
That 2016 study didn’t have information about a key health sector: urgent care centers and retail clinics, where a growing number of patients get their medical care.
CDC and Pew researchers tried to provide that information with the current study. They analyzed insurance claims from a 2014 database of more than 156 million patient visits to urgent care centers, retail clinics, hospital-based emergency departments and medical offices. The database only included patients with employer-sponsored insurance.
The data show that urgent care and retail clinics are “an underrecognized source of inappropriate antibiotic prescribing,” according to an accompanying commentary titled “Overprescribing in Urgent Care Clinics — The Fast and the Spurious.”
Researchers focused on respiratory conditions that don’t respond to antibiotics, such as colds, bronchitis, asthma, allergies, influenza and viral pneumonia. Urgent care centers prescribed antibiotics in nearly 46 percent of visits for these conditions. That rate was nearly three times higher than the 17 percent prescribed for antibiotic-inappropriate diagnoses at traditional medical offices, and almost twice as high as the rate at emergency departments, the study found.
One surprise: retail clinics had the lowest rate for these antibiotic-inappropriate diagnoses, 14 percent. Researchers said the proper use of antibiotics has been a focus of large retail clinic chains and could account for the lower percentage.
The new information suggests that unnecessary antibiotic prescribing in the United States is greater than what researchers estimated two years ago.
Antibiotic-resistant bacteria have evolved the ability to withstand drugs that ought to stop them. It’s part of the broader problem of antimicrobial resistance, which includes antibiotics as well as drugs to fight fungal, viral or parasitic infections. If these lifesaving medicines are rendered ineffective by multidrug-resistant superbugs, even the most minor infections would be untreatable, bringing back a level of danger not seen since the 19th century.