Aguilar, A.G.; Canals, P.C.; Tian, M.; Miller, K.A.; Piper, B.J. Decreases and Pronounced Geographic Variability in Antibiotic Prescribing in Medicaid. Pharmacy2024, 12, 46.
Aguilar, A.G.; Canals, P.C.; Tian, M.; Miller, K.A.; Piper, B.J. Decreases and Pronounced Geographic Variability in Antibiotic Prescribing in Medicaid. Pharmacy 2024, 12, 46.
Aguilar, A.G.; Canals, P.C.; Tian, M.; Miller, K.A.; Piper, B.J. Decreases and Pronounced Geographic Variability in Antibiotic Prescribing in Medicaid. Pharmacy2024, 12, 46.
Aguilar, A.G.; Canals, P.C.; Tian, M.; Miller, K.A.; Piper, B.J. Decreases and Pronounced Geographic Variability in Antibiotic Prescribing in Medicaid. Pharmacy 2024, 12, 46.
Abstract
Antibiotic resistance is a persistent and growing concern. Our objective was to analyze antibiotic prescribing in the United States (US) in the Medical Expenditure Panel System (MEPS) and to Medicaid patients. We obtained total MEPS prescriptions for eight antibiotics from 2013 to 2020. We extracted prescribing rates per 1,000 Medicaid enrollees for two years, 2018 and 2019, for four broad spectrum (azithromycin, ciprofloxacin, levofloxacin, and moxifloxacin) and four narrow spectrum (amoxicillin, cephalexin, doxycycline, and trimethoprim/sulfamethoxazole) antibiotics. Antibiotics in MEPS decreased from 2013 to 2020 by -38.7% with a larger decline for broad (-53.7%) than narrow (-23.5%) spectrum. Antibiotic prescriptions in Medicaid decreased by -6.7%. Amoxicillin was the predominant antibiotic followed by azithromycin, cephalexin, trimethoprim/sulfamethoxazole, doxycycline, ciprofloxacin, levofloxacin, and moxifloxacin. Substantial geographic variation in antibiotic prescribing existed with 2.8-fold between the highest (Kentucky = 855/1,000) and lowest (Oregon = 299) states. The South prescribed 52.2% more antibiotics (580/1,000) than the West (381/1,000). There were significant correlations across states in antibiotic prescribing. This study identified sizable disparities by geography in prescribing rates of eight antibiotics with over three-fold state level differences. Areas with high antibiotic prescribing rates, particularly for outpatients, may benefit from stewardship programs to reduce potentially unnecessary prescribing.
Medicine and Pharmacology, Epidemiology and Infectious Diseases
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