Data: Antibiotic Stewardship Efforts Don’t Seem to Apply to Some Medicaid Patients

Urgent care has taken a leadership position among healthcare settings when it comes to fighting antibiotic resistance. The Urgent Care Association initiated an Antibiotic Stewardship Commendation Program, wherein urgent care operators are recognized for fulfilling certain criteria demonstrating responsible antibiotic prescribing. And some large urgent care companies have instituted strict internal controls to ensure antibiotics are prescribed according to accepted guidelines. All those efforts, geared toward stemming antibiotic resistance, may be being undermined by inappropriate prescribing of antibiotics for Medicaid patients, according to a study published in the journal Health Affairs. In fact, 28% of antibiotic prescriptions filled by Medicaid patients were dispensed without any clinical assessment at all between 2004 and 2013; patients got prescriptions after describing their symptoms to someone with prescribing authority over the phone. For another 17%, the patient was seen by a clinician, but was not diagnosed with anything for which an antibiotic would be appropriate. Often, according to the researchers, it appears the prescriptions were written to achieve better patient satisfaction scores. Another possible factor found: Physicians underestimate how often antibiotics are prescribed, presumably concluding that there’s little harm in writing one more prescription that’s not in sync with the guidelines. The data can serve as a reminder that every antibiotic prescription matters—either because it’s what the patient truly needs, or for the contrary reason of negating urgent care initiatives to reduce life-threatening resistance.