Responsible Antibiotic Stewardship Requires Both Patients and Doctors to Change

The misuse and overprescribing of antibiotics is a public health issue that is significantly accelerating the rise and spread of antibiotic resistance, or “superbugs.” Overprescribing is eroding our ability to successfully treat infections. According to the Journal of the American Medical Association, over 30 percent of antibiotic prescriptions that were given between 2010 and 2011 were unnecessarily prescribed in outpatient care facilities in the U.S.

The implications are alarming. It is estimated that more than 2 million individuals are infected with antibiotic resistant bacteria in the U.S. each year, leading to over 23,000 deaths from difficult to treat infections. The public view of antibiotics as an easily acquired, safe, quick-fix for any illness needs to change. Antibiotics are too accessible, and as a result it is becoming harder to treat tuberculosis, urinary tract infections, pneumonia, and hospital-acquired infections, among other serious ailments.

At Aetna, we are focused on correcting this dangerous perception and public health problem while also working to reduce unnecessary antibiotic prescribing through several initiatives that seek to change provider behavior and raise patient awareness.

As a part of Aetna’s greater provider outreach initiative and through our collaboration with the CDC, we are leveraging our data analytics capabilities to help clinicians understand the severity of overprescribing and providing them with the resources to follow appropriate prescribing practices. So far, Aetna has sent more than 1,100 letters to “super-prescribers” throughout the United States with guidance from the CDC on avoiding antibiotic prescribing for acute bronchitis. Acute bronchitis is most commonly a viral infection, not a bacterial infection, in which case it cannot be successfully treated by antibiotics. This is just one condition for which antibiotics are often prescribed against CDC guidelines.

Recognizing clinicians that are appropriately administering antibiotics is also an important way in which we can encourage physicians to continue evidence-based prescribing. At Aetna, we have sent 127 “thank you” letters to clinicians who followed guidelines and did not prescribe antibiotics to treat acute bronchitis for any of their patients.

As a physician myself, I recognize the tremendous amount of pressure and responsibility practitioners encounter in managing patients. Clinicians want to make the safest decision for the individual but may have to contend with patients who demand treatments that are not in their best interest. By sending doctors the CDC guidelines, we are providing one more tool they can use in their conversations with patients about when antibiotics are appropriate. We also encouraged them to reach out to me directly with any questions.

Aetna is also working to help our members understand the scope of this issue and learn proper antibiotic practices so they can make educated decisions. It is imperative that patients know the importance of taking antibiotics exactly as directed and not sharing their prescriptions.

Aetna continues to explore opportunities to provide support to clinicians and patients as our society struggles to change its relationship with antibiotics.

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