How many urgent care clinics actually monitor and control antibiotic prescribing? (Photo By Joe… [+] Amon/The Denver Post via Getty Images)
They are called urgent care clinics. Not antibiotic clinics.
But a team from Centers for Disease Control and Prevention (CDC), the University of Utah, and The Pew Charitable Trusts analyzed insurance claims data and found that even when patients visited urgent care clinics for reasons that shouldn’t have required antibiotics, they still got prescribed antibiotics 46% of the time.
Nearly half the time? Pew. That’s a lot of inappropriate and unnecessary antibiotic prescribing.
The results of this analysis appeared in a research letter published in JAMA Internal Medicine. The team consisted of Danielle L. Palms, MPH, Lauri A. Hicks, DO, Monina Bartoces, PhD, and Katherine E. Fleming-Dutra, MD from the CDC, Adam L. Hersh, MD, PhD from the University of Utah, and Rachel Zetts, MPH and David Y. Hyun, MD from The Pew Charitable Trusts. The medical and pharmaceutical claims data came from the 2014 Truven Health Analytics MarketScan Claims and Encounter Database, consisting of people younger than 65 years of age who have employer-sponsored health insurance.
Here is a chart showing some of the key results from the analysis:
(Figure Courtesy of The Pew Charitable Trusts)
The Pew Charitable Trusts
As you can see, office-based clinics, retail clinics, emergency rooms, and urgent care clinics all have a fair amount of inappropriate antibiotic prescribing, otherwise known and antibiotic over-prescribing, otherwise known as “come on, stop trying to use missiles when you are trying to get rid of a housefly.” However, urgent care clinics are the worst of the 4 settings.
And we’re not talking about a few extra prescriptions here and there. Of the 2.7 million urgent care visits in the database, 39% resulted in antibiotic prescriptions and 17% resulted in antibiotic-inappropriate respiratory diagnoses.
Yes, the study does have its limitations. It is a sample of urgent care clinic visits and not all visits. It doesn’t include people without employer-sponsored insurance. It doesn’t include people over 65 years of age. Claims data does not always completely reflect what is happening in real life at the clinics. It represents what insurance codes the doctor enters when seeing a patient. However, the big picture is that doctors at urgent care clinics seem to be giving out way too many antibiotic prescriptions.
You could say that doctors and nurse practitioners at urgent care clinics are giving out antibiotic prescriptions like candy, but doctors shouldn’t really giving out that much candy either. Too many unnecessary antibiotics can lead to the proliferation of antibiotic-resistant bacteria, rendering the available antibiotic arsenal less and less useful when you really need antibiotics to save your life. I have written in Forbes previously about how our society is running out of antibiotics and how super-scary, Thanos-like, untreatable strains of bacteria have been emerging because of antibiotic overuse.