TUESDAY, May 31, 2022 (HealthDay News) — Antibiotics inappropriately prescribed to children have spiked U.S. health care costs by at least $74 million in just one year, new research shows.
Antibiotics can make a difference in bacterial infections, but not in viral illnesses.
Prescribing them unnecessarily or choosing the wrong antibiotic for a particular type of infection also adds to the threat of drug-resistant superbugs, the study Noted.
“Inappropriate prescribing of antibiotics is unfortunately very common and results in adverse drug events and millions of dollars in preventable healthcare costs,” said lead author Anne Mobley Butler, assistant professor of medicine at the Washington University School of Medicine in St. Louis.
“Sometimes parents think the worst that can happen is that the antibiotic just won’t help their child,” Butler said in a university press release. “But antibiotics are not harmless – they can cause adverse drug events. Clinicians need to ensure that antibiotics are only used in the way most likely to benefit the patient.”
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Working with the Pew Charitable Trusts, Butler and colleagues analyzed private health insurance claims for children aged 6 months to 17 years who were diagnosed with one of eight common infections in 2017.
Three of the infections were bacterial: ear infections with pus, sore throat and sinus infections. Five were viral: ear infections without pus, bronchitis, bronchiolitis, flu and cold.
Researchers identified 2.8 million children who were seen for one or more of these eight infections in clinics, emergency rooms, urgent care centers and doctors’ offices between April 1, 2016 and September 30, 2018.
Children who were prescribed antibiotics that were unnecessary or inappropriate for their type of infection were eight times more likely to develop complications such as diarrhea and rash than children treated according to standard medical guidelines.
A previous study suggested that about 29% of antibiotic prescriptions for non-hospitalized children were inappropriate.
Children who received an antibiotic not recommended for bacterial infections were up to eight times more likely to develop a life-threatening gut infection Clostridioides difficult (C. difficult). They were also at greater risk of diarrhea not caused by C.diff, nausea, vomiting and abdominal pain, as well as severe allergic reactions such as anaphylaxis.
Children who received antibiotics unnecessarily for certain viral infections had a higher risk of developing rashes or unspecified allergies, the study also found.
“Taking antibiotics when they’re not needed, or taking the wrong antibiotic when needed, accelerates the threat of dangerous superbugsand has serious consequences for individual patients,” said study co-author Dr. David Hyun, who leads the Pew Charitable Trusts Antibiotic Resistance Project.
“We hope this research will serve as a roadmap to help health systems, insurers and other healthcare organizations as they strive to strengthen efforts to improve prescription of antibioticsprotect children’s health and save money,” Hyun said in the statement.
For the year studied, the inappropriate selection of antibiotics for bacterial ear infections costs families and insurance companies an average of $56 per case, or about $25.3 million in excess costs to the ear. nationwide, according to the study. But that figure was only for children with private insurance. The total for all children is likely much higher, according to the study.
Badly treated sore throats cost $21.3 million; sinus infections, $7.1 million; flu, $1.6 million; and colds cost $19.1 million nationally for privately insured children.
Unnecessary antibiotic prescriptions for viral bronchitis or bronchiolitis did not result in additional medical complications or cost.
Surprisingly, one exception was inappropriate prescriptions for viral ear infections, which saved $15.4 million nationwide. The researchers suggested it could be a diagnostic coding error where bacterial ear infections were incorrectly flagged as viral, not a true save.
“This study continues to show that we need to do a better job of ensuring that antibiotics are used appropriately in all health care settings,” said lead author Dr. Jason Newland, professor of pediatrics at the WUSTL. “Our failure to do so has real costs, both to children’s health and to our collective wallet.”
The results were published on May 26 in Open JAMA Network.
The American Academy of Pediatrics answers questions about antibiotics and children.
SOURCE: Washington University School of Medicine in St. Louis, press release, May 26, 2022