More than 60% of patients receive antibiotics for acute upper respiratory infections, and many of these cases lead to adverse health events such as Clostridium difficile (C. diff) infection, according to a large new study.
Investigators examined insurance claims data on 51 million patient encounters in the United States over a period of 15 years. They tracked adverse events that followed antibiotic prescriptions for acute upper respiratory infections, looking specifically for candidiasis, diarrhea, C. diff infection or a mix of those outcomes.
Patient outcomes were compared to those in patients who did not receive antibiotics for their upper respiratory infection.
Adverse events rise by 30%
The relative likelihood of an adverse event rose 30% for patients receiving antibiotics, they found. Not only were some of the most dangerous antibiotics commonly used, despite lack of indication, but 1 in 300 of patients with those prescriptions developed side effects that required a doctor’s follow-up or hospitalization.
For example, antibiotics use was found to result in 5.7 additional cases of C. diff per 100,000 outpatient prescriptions. Adverse health events occurred in 1 in 1,150 prescriptions overall. And female patients were more likely to be diagnosed with any of the adverse outcomes tracked in the study, the researchers noted.
‘Widespread harm’
The scale of the problem is enormous, said Harris Carmichael, MD, the study’s principal investigator and a hospitalist at Intermountain Health in Salt Lake City, UT.
“These findings underscore that inappropriately giving patients antibiotics is causing real and widespread harm,” he said in a statement. “Having these kinds of side effects for one in a few hundred, or even a thousand, patients may not seem like a lot, but when you look at this problem on a population health level, we’re talking about hundreds of thousands of adverse events severe enough that these patients needed additional care from a doctor.”
In related news, another new study from Norway has found that antibiotics do not protect hospitalized patients with viral respiratory infections. In fact, patients with these infections who receive antibiotics have double the likelihood of dying than those who are not given antibiotics, reported CIDRAP News.
Full findings for the U.S. study were published in the Journal of Internal Medicine.
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