Trends in U.S. Antibiotic Use, 2018

Antibiotic resistance remains a pressing global public health problem. This second report on antibiotic use in the United States highlights encouraging progress made over the past year in the collection and availability of data for both human health care and animal agriculture settings. Despite these gains, more comprehensive data are needed to enable policymakers to track trends, refine priorities, and target interventions to reduce unnecessary antibiotic use and slow the emergence of resistance.

The U.S. has a relatively high antibiotic prescribing rate. For example, an analysis of 2004 outpatient data from the U.S. and 27 European countries showed the U.S. had the fourth-highest prescribing rate. Although data are incomplete, existing evidence suggests that a significant portion of antibiotic use across U.S. health care settings s inappropriate—from primary care offices and emergency rooms to hospitals and long-term care facilities. Policy options and incentives will vary depending on the setting, but enhanced data are needed across all settings in order to design targeted and effective stewardship interventions that will improve the use and preserve the effectiveness of this valuable resource.

Providers in doctors’ offices, emergency departments, and other outpatient settings in the U.S. wrote nearly 270 million antibiotic prescriptions in 2015, amounting to 838 antibiotic prescriptions for every 1,000 people. Although this was essentially unchanged from 2014, data going back to 2011 indicate a slow downward trend in outpatient prescribing. Nonetheless, U.S. rates remain high by international standards. In 2015, for example, U.S. outpatient prescribing was more than 2½ times Sweden’s rate that year.

Source: PEW