Sun Sentinel Broward Edition

Antibiotic use drops in U.S.

Drugs’ usage falls 9 percent from 2010-2016

- By Amy Goldstein The Washington Post

The use of antibiotic­s among Americans with commercial health insurance has decreased during the past several years, according to a new analysis that neverthele­ss shows lingering variations for different ages and in different parts of the country.

The study released Thursday provides the latest evidence of how doctors and patients have begun to heed warnings that excessive antibiotic use breeds dangerous drug resistance and “superbug” bacteria. The analysis is based on 173 million insurance claims from people under age 65 with Blue Cross Blue Shield coverage who filled prescripti­ons from 2010-2016.

It is a sequel of sorts to research by the federal Centers for Disease Control and Prevention, which found a smaller decline and comparable age and geographic variations. The CDC reported a 5 percent decrease overall from 2011 to 2014 in antibiotic prescripti­ons written in outpatient settings such as doctors’ offices, clinics and hospital emergency rooms. The study by the Blue Cross Blue Shield Associatio­n found that 9 percent fewer antibiotic­s prescribed in outpatient settings were filled in 2016, compared with 2010.

Efforts to make sure that doctors and patients rely on antibiotic­s only when necessary have gained prominence in recent years. A study last year by the CDC and the Pew Charitable Trusts was the first to try to quantify the overuse, concluding that nearly one-third of the antibiotic­s prescribed in outpatient settings were not needed. Many of these estimated 47 million unnecessar­y prescripti­ons were for colds or other respirator­y illnesses that are caused by viruses and do not respond to antibiotic­s.

The Blue Cross Blue Shield analysis of 31 million commercial­ly insured customers a year found that the steepest decrease in filled prescripti­ons was for children — a drop of 16 percent, compared with 6 percent for adults. The prescripti­ons filled for infants fell the most — 22 percent.

As with earlier research, the analysis also found wide geographic difference­s, with people in the South and Appalachia tending to fill prescripti­ons at rates significan­tly greater than those in New England and along the West Coast. The highest rates were in Mississipp­i, Alabama and Arkansas. However, from 2010 to 2016, the rates fell in all states except Delaware, Illinois and Nebraska.

Among types of antibiotic­s, the decrease was greatest among broad-spectrum drugs covering a wide range of bacteria and most likely to lead to drug-resistance.

Trent Haywood, chief medical officer for the Blue Cross Blue Shield Associatio­n, said in a statement that the study suggests public health efforts to reduce inappropri­ate use “appear to be achieving measurable results.” But, he said, “there are further improvemen­ts to be made.”

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