JAPhA study shows trends in antibiotic prescribing by provider type

Research shows that the proportion of broad-spectrum antibiotic prescriptions varies significantly among physicians, nurse practitioners, physician assistants, and dentists

Although antibiotic prescriptions are decreasing overall in the U.S., prescriptions of broad-spectrum antibiotics such as penicillin, macrolides, and quinolones are increasing. Because use of broad-spectrum antibiotics can lead to resistance, researchers at the University of Illinois at Chicago, the Centers for Disease Control and Prevention, and IMS Health investigated prescriber trends over time by provider group as a way to customize stewardship efforts.

In the study, published online in the Journal of the American Pharmacists Association, data from a nationally representative database of outpatient antibiotic prescriptions in the U.S. from January 1, 2005, through December 31, 2010, including oral and injectable systemic antibiotic prescriptions dispensed from retail community pharmacies, mail service pharmacies, and medical clinics, were analyzed. Providers were classified as physicians, nurse practitioners (NPs), physician assistants (PAs), and dentists.

Results of the study showed that over 6 years, prescriptions for broad-spectrum agents and for antibiotics overall decreased for physicians while increasing for NPs and PAs. They also found that dentists prescribe a large number of antibiotics compared with NPs and PAs. The study authors conclude that interventions should be designed to reverse increasing prescribing trends, especially of broad-spectrum agents prescribed by NPs and PAs, and that stewardship efforts should also be targeted towards dentists.