Antibiotic Use, Costs Show Wide Regional Variations

In an invited commentary, Ralph Gonzales, MD, and colleagues at the University of California San Francisco, said that the two studies "are important reminders that the United States still has a long way to go in reducing antibiotic overuse" and "raise the question about why the problem of overprescribing exists."

They point out that numerous clinician-targeted programs, multi-agency task forces, and public health efforts have attempted to reduce overuse through education. Rates have gone down, they say, but not enough.

That's because there are significant obstacles to achieving behavior change. For starters, adverse events linked to use of antibiotics are rare events, and resistant strain emergence is not immediately noticed, they wrote.

If providers refuse patients demands for antibiotics when the drugs aren't warranted, the consequence may be the patient's "loss of trust in the clinician and clinicians may fear that patients may lose that trust in them."

"We need to find better ways to compel individuals and organizations to address the significance of the problem of antibiotic overuse and to increase the readiness for change and quality improvement of ambulatory practices in the United States," they wrote.