A new analysis of antibiotics doled out during US ambulatory care visits in 2015 indicates that more than 40% were inappropriate, and nearly 1 in 5 prescriptions had no documented reason for being written.

In a study published yesterday in the British Medical Journal (BMJ), researchers looking at survey data on more than 28,000 sample visits to office-based healthcare providers in 2015—a sampling that represents 990.9 million visits nationwide—found that antibiotics were prescribed in 13.2% of visits. Of the 130.5 million antibiotic prescriptions given out during these visits, only 57% were for a bacterial infection or other condition for which antibiotics are commonly, and appropriately, prescribed.

Twenty-five percent of the antibiotic prescriptions analyzed were deemed inappropriate because they were written for conditions, like upper respiratory infection, for which antibiotics aren’t indicated but are commonly prescribed. But 18%—representing roughly 24 million prescriptions—lacked either an appropriate or inappropriate indication.

“When there’s no indication documented, it’s reasonable to think that at least some of the time, the prescription was written without an appropriate indication present,” lead study author Michael J. Ray, MPH, a researcher at Oregon State University’s College of Pharmacy, said in a university press release.

Credit: iStock, Drazen Zigic

The problem of undercoding

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Photo credit:  Maksym Kozlenko [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons