Antibiotic Overprescribing in the Outpatient Setting

Kirsten Miller, Pharm.D., FirstLight Health System

Antibiotics are important medications used to treat many bacterial infections commonly seen in the outpatient setting, including strep throat and ear infections. When indicated, antibiotics are an integral part of preventing the spread of illness and reducing the risk of potential complications of disease. On the other hand, antibiotic treatment will not reduce infection transmission or lead to cure when prescribed for viral illness.

Research shows antibiotics are frequently prescribed for symptoms including sore throat and cough when they are not indicated. Viruses cause many common illnesses seen in the outpatient setting and patients do not benefit from antibiotic therapy due to the viral origin. According to an IDWeek 2018 study, almost half of the outpatient antibiotics prescribed were given without an infection-related diagnosis. The study included more than 500,000 outpatient antibiotic prescriptions given to patients from November 2015 to October 2017. It was determined that 46% of the total antibiotic prescriptions were prescribed without an infection-related diagnosis. This included 29% of antibiotics associated with a diagnosis that was non-infectious in nature, including high blood pressure or annual visit. Data also showed that 17% of prescriptions were written without a diagnosis at all, which may indicate antibiotic prescribing for unclear or inappropriate reasons.

It is important that all healthcare professionals work together to ensure proper use of antibiotics. We can accomplish this by promoting appropriate utilization, selection, dose, and duration of antibiotics. Antibiotic stewardship is essential to preserve antibiotic effectiveness, prevent harmful side effects that may be caused by the inappropriate use of antibiotics, and protect the public from antibiotic-resistant infections. 


1. Infectious Diseases Society of America. "Outpatient antibiotic overprescribing rampant: Nearly half written without infection diagnosis, suggests study of 500,000-plus prescriptions." Updated October 5, 2018. (accessed November 17, 2018).