Use of Antibiotics

TLDR

Antibiotics are widely overused in this country, with inappropriate prescribing common, leading to waste and frequent adverse reactions, prompting concern from regulators and experts. The study aims to control the use of the most expensive antibiotics in hospitals and emphasize clinical pharmacology training throughout medical school curricula. Hospital studies show that over half of antibiotics prescribed are unnecessary or inappropriate, costing 19–34 % of pharmacy budgets, with cephalosporins and aminoglycosides comprising 69 % of expenses, yet the use of cephalexin has been successfully reduced.

Abstract

Antibiotics are overused in this country. Concern about the problem has been expressed by a Senate investigating committee, the Food and Drug Administration, and by many authorities in the field. Inappropriate use in office practice is common. This is both wasteful and associated with a high frequency of undesirable reactions. Studies in hospitals show that more than half the antibiotics used are not needed, or that an inappropriate agent is chosen, or the dose is incorrect. Antibiotics accounted for 19% to 34% of the pharmacy budgets in three representative hospitals in Madison, Wisconsin. Cephalosporins and aminoglycosides (mostly gentamicin) accounted for 69% of all hospital antibiotic costs. The use of cephalexin, a drug whose cost to the hospital almost equaled all other oral antibiotics combined, has been successfully controlled. Usage of the most expensive agents in hospitals should be controlled. Training in clinical pharmacology should be emphasized throughout the medical school curriculum.