Study Indicates Overuse of Antibiotics in the VA

Antibiotic overuse is a common observation across the healthcare spectrum and a new study published in the Annals of Internal Medicine examines prescribing pratices within the Department of Veterans Affairs (VA). The retrospective cross-sectional study that included VA systems across the nation as well as the CDC evaluated antibiotic prescription trends over an 8-year period (2005 to 2012) in all emergency departments and primary and urgent care clinics in the VA health system.

The patients whose electronic health records were examined all had a primary diagnosis of acute respiratory infection (ARI) with typically low proportions of bacterial infection. Patients with infections or comorbid conditions that indicated antibiotic use were excluded. The authors measured overall antibiotic prescription; macrolide prescription; and patient, provider, and setting characteristics.

The study found that 10% of healthcare providers write an antibiotic prescription for nearly every patient (95% or more) with a cold, bronchitis, or other ARI. Importantly, the study pointed to variation in provider prescribing practices having a biger influence on variation in antibiotic prescription, more than patient characteristics, standards of practice at different hospitals, or clinical settings.

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