Outpatient antibiotic over prescribing rampant without diagnosis A large study in USA

Outpatient antibiotic over prescribing rampant without diagnosis A large study in USA 

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For any suspected disease inflammatory in origin whether by bacteria,virus,fungus ,trauma or tumor an antibiotic is prescribed usually a Doctor.The condition in developing country Like India or Underdeveloped country is more worsened as Antibiotics are given over the medicine shop counter by pharmacist or even uneducated medicine seller or Ayush or other therapy healers as quack prescribe it whether there is a bacterial infection present or not without deciding whether this antibiotics give will kill bacteria or not producing resistant TB,Malaria, Leprosy ,Beta lactame resistant,New Delhi metallo-ß-lactamase-1 bacterias or superbugs which will bring to a state when resistant bacteria like a monster will kill every body as no antibiotics will kill them if we donot control use of Antibiotics .Such study in USA speaks out in what danger and dreadly conditon Human is going.

                     Clinicians prescribed antibiotics without an infection-related diagnosis nearly half of the time and one in five prescriptions were provided without an in-person visit, according to research being presented at IDWeek 2018. The study, which is the first to look at overall outpatient antibiotic prescribing, analyzed more than half a million prescriptions from 514 outpatient clinics.

           Previous research has found antibiotics often are prescribed for certain symptoms (such as a sore throat or cough) when they shouldn't be.Most of these types of illnesses are caused by viruses and therefore don't benefit from antibiotics, which only treat bacterial infections.

            "We looked at all outpatient antibiotic prescribing and results suggest misuse of these drugs is a huge problem, no matter the symptom," said Jeffrey A. Linder, MD, MPH, lead author of the study and chief of the Division of General Internal Medicine and Geriatrics at Northwestern University Feinberg School of Medicine, Chicago. "We found that nearly half the time, clinicians have either a bad reason for prescribing antibiotics, or don't provide a reason at all. When you consider about 80 percent of antibiotics are prescribed on an outpatient basis, that's a concern."

     The research, analyzed 509,534 outpatient antibiotic prescriptions given to 279,169 patients from November 2015 through October 2017 by 2,413 clinicians at 514 clinics. The prescribers included physicians, attending physicians, nurse practitioners, and physician assistants in specialties including primary care internal medicine, obstetrics/gynecology, family medicine, dermatology, cardiology, and gastroenterology. Researchers determined 46 percent of antibiotics were prescribed without an infection-related diagnosis: 29 percent noted something other than an infection diagnosis (such as high blood pressure or annual visit) and 17 percent were written without a diagnosis indicated. Researchers hypothesize that some of that is related to sloppy diagnosis coding, but much of it reflects antibiotic prescribing for vague or inappropriate reasons, such infections that are caused by viruses, said Dr. Linder.

            Of the 20 percent of antibiotics that were prescribed outside of an in-person visit, most were by phone (10 percent). Others were via an electronic health record system that allows prescription writing but there is no opportunity to gather information about symptoms or testing (4 percent), refill (4 percent) and online portal (1 percent). There are some cases where that may be appropriate, such as for women who suffer from recurrent urinary tract infections or teens taking antibiotics for acne. Researchers will analyze which of those prescriptions were appropriate in the next phase of research."Despite 40 years of randomized controlled trials showing antibiotics don't help for most coughs and sinus infections, many people are convinced they will not get better without an antibiotic and specifically call the doctor requesting one," said Dr. Linder.

                  If this is the condition in advanced state as USA where no ober the counter medicines are sold and every antibiotic is audited then what study in our country will reveal is well evident and we have to comeforward on personal level as physician or on Government side too making stringent law to regulate use of Antibiotics as soon as possible.

              Please write your opinion as physician on this vibrant topic.