Hospitals continue to overuse antibiotics despite warnings that pervasive use can lead to drug resistance and cause billions of dollars in excess healthcare costs, according to a retrospective analysis of 505 hospital members of the Premier health alliance.
Inappropriate use of antibiotic combinations was noted in nearly 80% of the facilities analyzed, and overuse of the most common therapies led to an excess spending of nearly $13 million.
Healthcare organizations are encouraged to develop a list of antibiotic “never combinations”—those for which there is no evidence to support continued use—and create an alert system to flag when the drugs are ordered.
Combating overuse of antibiotics remains a major public health concern. Their use is the most important factor leading to antibiotic resistance around the world, according to a Centers for Disease Control and Prevention alert issued last year.
The federal agency estimates at least 2 million people in the U.S. each year become infected with drug-resistant bacteria and at least 23,000 die as a direct result. Over the past few years, the CDC, Food and Drug Administration and several medical specialty organizations through the Choosing Wisely campaign have issued warnings or recommendations to encourage safe use of antibiotics.
Using administrative data from Premier, the company’s researchers and the CDC’s associate director for Healthcare Associated Infection Prevention Programs, Dr. Arjun Srinivasan investigated the incidence and economic impact of potentially overused antibiotics used by hospitals between Jan. 1, 2008, and Dec. 31, 2011. Of the 505 hospitals included, researchers found evidence of “potentially inappropriate, redundant antimicrobial coverage” for 23 antimicrobial combinations in 78%, or 394 of the hospitals. This accounted for 32,507 individual cases of patients who received at least two consecutive days of one or more of the antibiotic combinations.
