Inappropriate antibiotics for nonhospitalized kids cost US at least $74 million: Such prescriptions can cause complications including diarrhea, rashes

Antibiotics inappropriately prescribed to nonhospitalized children resulted in at least $74 million in excess health-care costs in the U.S. in 2017, according to a new study from Washington University School of Medicine in St. Louis and The Pew Charitable Trusts.

Children who were prescribed unneeded or unsuitable antibiotics in outpatient settings, such as doctors’ offices and urgent care centers, also were up to eight times more likely to develop complications such as diarrhea and skin rashes than children who were treated according to standard medical guidelines.

The findings, published May 26 in JAMA Network Open, highlight the need to better manage antibiotic use outside hospital settings.

“Inappropriate prescribing of antibiotics is unfortunately very common and leads to adverse drug events and millions of dollars in avoidable health-care costs,” said lead author Anne Mobley Butler, PhD, an assistant professor of medicine in the Division of Infectious Diseases at Washington University. “Sometimes parents think that the worst that could happen is that the antibiotic just won’t help their child. But antibiotics are not harmless — they can cause adverse drug events. Clinicians needs to insure that antibiotics are only used in the way that is most likely to benefit the patient.”

Antibiotics kill bacteria, not viruses, but doctors still frequently prescribe antibiotics for viral infections. For bacterial infections, antibiotics can be helpful, but it is important to choose an appropriate antibiotic agent, and doctors do not always follow guideline recommendations. A previous study suggests that about 29% of antibiotic prescriptions for nonhospitalized children nationwide are inappropriate.

On a population level, antibiotic use drives the development of antibiotic-resistant bacteria. Such bacteria cause difficult-to-treat infections that lead to 35,000 deaths in the U.S. each year. But less is known about the individual health risks and economic costs associated with inappropriate antibiotic use.

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