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Outpatient Antibiotic Prescribing Down in VA System

Annual percent decrease for all outpatient antibiotic use averaged 3.9 percent; largest decrease seen in ciprofloxacin use at 12.6 percent

FRIDAY, July 16, 2021 (HealthDay News) — In the Veterans Affairs (VA) system, outpatient antibiotic prescribing decreased from 2011 to 2018, according to a study presented at the annual European Congress of Clinical Microbiology and Infectious Diseases, held virtually from July 9 to 12.

Haley Appaneal, Pharm.D., from the Providence VA Medical Center in Rhode Island, and colleagues examined trends in antibiotic use among VA outpatient clinics across the United States. Using VA pharmacy datasets, dispensed antibiotic prescriptions were assessed in the VA outpatient setting from 2011 to 2018. The annual utilization in days of therapy (DOT) per 100 outpatient visits was calculated for all antibiotics and individually for the most common antibiotics.

The researchers identified several significant trends in outpatient antibiotic utilization over eight years. For all outpatient antibiotic use, the average annual percent decrease was 3.9 percent, decreasing from 39.6 to 29.4 DOT/100 visits in 2011 and 2018, respectively. The largest reduction was seen in ciprofloxacin use, which decreased 12.6 percent per year. Significant decreases were also seen in amoxicillin and cephalexin (average annual percent changes, −2.9 and −2.1 percent, respectively). The highest utilization rates were seen for doxycycline, azithromycin, and amoxicillin/clavulanate; however, during the study period, trends in their utilization remained stable.

“We have seen positive steps taken to reduce antibiotic use in VA outpatient clinics, community-based outpatient clinics, emergency departments, and other outpatient settings, and health care teams should be congratulated for their ongoing work to reduce unnecessary antibiotic use,” Appaneal said in a statement.

Several authors disclosed financial ties to the pharmaceutical industry.

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