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February 24, 2015 12:00 AM

Antibiotic overuse targeted by specialty groups as problem persists

Sabriya Rice
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    The Infectious Diseases Society of America, seeking to rein in the over-prescribing of antibiotics, has published a list of instances in which both physicians and patients should question their use.

    “Awareness will cause them to think twice,” said Andrés Rodríguez, director of practice and payment policy for the IDSA, whose new list includes four common conditions and one test that often lead to antibiotic prescriptions.

    Specifically, the IDSA suggests antibiotics could often be avoided (PDF) for treatment of asymptomatic bacteria in the urine; acute upper respiratory infections; venous ulcers in the lower legs; and a heart condition in which the mitral valve does not open and close properly. It also notes in its latest list that testing for a Clostridium difficile infection should not be done in the absence of diarrhea.

    Overprescribing of the drugs has resulted in increased prevalence of drug-resistant bacteria and superbugs, a problem recently deemed a threat to national security.

    The society is one of the latest to work with the Choosing Wisely campaign to outline circumstances where both patients and their doctors should be hesitant of an antibiotic recommendation.

    Choosing Wisely aims in part to help providers reduce harm and prevent unnecessary and duplicative medical practices by sharing short lists of key evidence-based treatments. The ISDA is one of several specialty organizations—including the American Academy of Allergy, Asthma & Immunology, American College of Emergency Physicians and American Academy of Dermatology—to include recommendations for safe antibiotic use.

    Despite various warnings that antibiotic overuse can lead to drug-resistant superbugs like MRSA and C. diff, it continues to be a problem across the nation. Many hospitals continue to overprescribe antibiotics, according to some reports.

    Last year, President Barack Obama described the rapid growth in antibiotic resistance as a threat to national security, and earlier this year appropriated $993 million to tackle antibiotic-resistant infections in his fiscal 2016 budget proposal.

    Rodríguez of the IDSA says emphasizing the problem again and again is a necessary step.

    “The lists provide succinct guidance physicians can reflect upon then begin to change their practice.” If a particular problem shows up consistently on more than one Choosing Wisely list or from other awareness groups, “it lends weight to the recommendations,” he said.

    Follow Sabriya Rice on Twitter: @sabriyarice

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