Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Antibiotic Use Among US Older Adults

BMJ; ePub 2018 Jul 27; Olesen, Barnett, et al

Overall antibiotic use and potentially inappropriate use remained relatively steady among US older adults in 2011-2015, but the use of individual antibiotics saw divergent changes in use, a recent study found. The observational study used US Medicare administrative claims in 2011-2015 and examined overall rates of antibiotic prescription claims, rates of potentially appropriate and inappropriate prescribing, rates for each of the most frequently prescribed antibiotics, and rates of antibiotic claims associated with specific diagnoses. Researchers found:

  • The number of antibiotic claims fell from 1364.7 to 1309.3 claims per 1,000 beneficiaries per year in 2011-2014 (adjusted reduction of 2.1%), but then rose to 1364.3 claims per 1,000 beneficiaries per year in 2015 (adjusted reduction of 0.20%).
  • Potentially inappropriate use of antibiotics decreased slightly in 2011-2014 (3.9%).
  • However, prescribers’ use of individual antibiotics had no consistent association with guideline changes.


Olesen SW, Barnett ML, MacFadden DR, Lipsitch M, Grad YH. Trends in outpatient antibiotic use and prescribing practice among US older adults, 2011-15: Observational study. [Published online ahead of print July 27, 2018]. BMJ. doi:10.1136/bmj.k3155.

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