Reduced antibiotic prescribing is associated with increased hospital admissions

New research indicates that efforts to reduce antibiotic resistance led to a decrease in the prescribing of antibiotics by doctors yet an increase in hospitalizations for respiratory infections like pneumonia.

In analyses of more than 15.5 million hospitalizations and 5.5 million outpatient visits per year over 8 years, this trend was particularly strong between 1998 and 2002.

The study, published in the Journal of the Royal Society of Medicine, examined the relationship between antibiotic prescribing for acute bronchitis and cough with hospital admissions for respiratory infections in the USA.

"An unintended consequence of a strategy to decrease antibiotic resistance appears to be a practice that limits the use of antibiotics in cases where such drugs would be beneficial," said Professor Arch Mainous from the Medical University of South Carolina.

"There are good reasons to focus on reducing antibiotic resistance in the community; however, the focus needs to be on encouraging the judicious and appropriate use of antibiotic prescriptions and not a blanket limit on the use of antibiotics.

"The increase in hospital admissions for respiratory illness in the US is consistent with similar findings in Britain," he said.

Professor Mainous said further research on ecological and individual level analyses was urgently needed.

"The association between antibiotic prescribing and hospital admissions needs to be more closely understood to assist any examination of the appropriateness of current physician practice," he said.

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Mainous A, Saxena S, Hueston W, Everett C and Majeed A. Ambulatory antibiotic prescribing for acute bronchitis and cough and hospital admissions for respiratory infections: time trends analysis. Journal of the Royal Society of Medicine 2006; 99: 385-362

JRSM is the flagship journal of the Royal Society of Medicine. It has been published continuously since 1809. Its Editor is Dr Kamran Abbasi.

The article is available free at www.jrsm.org.

See accompanying PDF.


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