June 8, 2022

In The News – Inappropriate Antibiotics for Nonhospitalized Kids Cost US at Least $74 Million

Reporting on a study from Washington University School of Medicine in St. Louis and The Pew Charitable Trusts, Medical Xpress shares the cost of inappropriately prescribed antibiotics to children cost an excess of at least $74 million in the United States. Data from private health insurance claims for children six months to 17 years of age who were diagnosed with any of eight common infections (three bacterial and five viral) were analyzed. The children were seen in clinics, emergency departments, urgent care and doctors’ offices.

The inappropriate use of antibiotics in these children cases created complications in both the immediate and longer term. Children who received unnecessary antibiotic treatment for bacterial infections were three-to-eight times higher risk of developing Clostridiodes difficile infection. Additionally, they were also at elevated risk of non-C. diff-related diarrhea, plus, nausea, vomiting, abdominal pain, and serious allergic reactions. For those with viral infections, children unnecessarily receiving antibiotics were at higher risk of skin rashes and allergies than who appropriately did not receive an antibiotic. Inappropriate use can also contribute to antibiotic failures and additional follow-up care and prescriptions.

In 2017 (the year of the study), inappropriate selection for bacterial ear infections amounted to $25.3 million in excess costs, sore throats $21.3 million, sinus infections $7.1 million, flu $1.6 million, and common colds $19.1 million. The only outlier was viral ear infections, which saw a reduction of $15.4 million. Researchers suggest that this was due to diagnostic coding errors, at least in part. Researchers also point out that data came only from private health insurance covered children and the total cost would likely be significantly higher.

While many institutions have established antibiotic stewardship programs to promote the appropriate use of antibiotics such programs are less common in outpatient settings like the ones used in the study.

Study co-author and PIDS member David Hyun said the hope is “[T]his research will serve as a roadmap to help health systems, insurers and other health care organizations as they work to strengthen efforts to improve antibiotic prescribing, protect children’s health.” Also in the story, PIDS member Jason Newland added, “Our failure to do [a better job of making sure antibiotics are used appropriately in all health-care settings] has real costs, both to the health of children and to our collective wallet. We know how to prescribe antibiotics according to guidelines, and it’s time we started putting more effort into making sure antibiotics are always used correctly.”

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