antiobiotics, pill, in hands

Antibiotics, chiefly azithromycin, were commonly prescribed to Medicare beneficiaries diagnosed with COVID-19 during the pandemic’s first year, CDC researchers have found.

Investigators analyzed Medicare records from April 2020 to April 2021 to identify beneficiaries with a COVID-19 outpatient visit (including telehealth visits) and associated antibiotic prescriptions. Fully 30% of outpatient visits during this time were linked to an antibiotic prescription and more than half of these were for azithromycin, reported Sharon V. Tsay, M.D., and colleagues from the agency’s Division of Healthcare Quality and Promotion.

Not only have randomized clinical trials not shown any benefit of azithromycin in treating COVID-19, but treatment of the disease with these drugs has been linked to antimicrobial resistance, the authors wrote in a research letter published last week in JAMA.

The highest rates of antibiotic prescribing were in the emergency department, followed by telehealth visits. Urgent care centers, meanwhile, were most likely to prescribe azithromycin. Prescribing rates were also higher for non-Hispanic White beneficiaries than for those in other racial and ethnic groups, they reported. 

“These observations reinforce the importance of improving appropriate antibiotic prescribing in outpatient settings and avoiding unnecessary antibiotic use for viral infections such as COVID-19 in older adult populations,” the authors concluded.

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