Urgent care clinics are prescribing too many unnecessary antibiotics.
Nearly half of patients who go to urgent care clinics seeking treatment for a flu, cold or other conditions that do not require antibiotics received a prescription for one anyway. That is three times as often as antibiotics are prescribed to patients with the same illnesses in traditional doctors’ offices, according to a study published Monday.
Patients who get unnecessary antibiotics are at risk for severe side effects, even with just one dose of the medicine, doctors say. Inappropriate use of these lifesaving drugs also puts everyone else at risk because overuse accelerates the emergence of resistant bacteria, or “superbugs,” that cannot be stopped with drugs.
An analysis published in the journal JAMA Internal Medicine is the first study of antibiotic prescribing in the growing number of urgent care centers and retail health clinics, which together serve millions of patients at thousands of locations across the United States each year. Retail clinics are embedded in grocery stores, big-box stores and pharmacy chains. Urgent care clinics typically treat more pressing injuries or illnesses that do not require an emergency room visit.
Antibiotic overuse is an enormous and growing problem around the world. If left unchecked, a United Kingdom report has forecast, antibiotic-resistant bacteria could result in 10 million deaths each year by 2050 — more than the number of people killed by cancer — at a cost of $100 trillion to the global economy.
In the United States, nearly one-third of antibiotics — or about 47 million prescriptions dispensed every year — in doctor’s offices, emergency rooms and hospital-based clinics are not needed and not effective, according to a 2016 study by the Centers for Disease Control and Prevention and the Pew Charitable Trust, the first to quantify the depth of the U.S. problem.
That 2016 study did not have information about a key health sector: urgent care centers and retail clinics, where a growing number of patients get their medical care.
CDC and Pew researchers tried to provide that information with this latest study. They analyzed insurance claims from a 2014 database of more than 156 million patient visits to urgent care centers, retail clinics, hospital-based emergency departments and medical offices. The database only included patients with employer-sponsored insurance.
The data show urgent care and retail clinics are “an underrecognized source of inappropriate antibiotic prescribing,” according to an accompanying commentary titled “Overprescribing in Urgent Care Clinics — The Fast and the Spurious.” The commentary was written by physicians Michael Incze, Rita Redberg and Mitchell Katz. Incze and Redberg are doctors at the University of California, San Francisco; Katz is chief executive of New York City’s public health system. None was involved in the study.
Researchers focused on respiratory conditions that do not respond to antibiotics, such as colds, bronchitis, asthma, allergies, influenza and viral pneumonia. Urgent care centers prescribed antibiotics in nearly 46 percent of visits for these conditions. That rate was nearly three times higher than the 17 percent prescribed for antibiotic-inappropriate diagnoses at traditional medical offices and almost twice as high as the rate at emergency departments, the study found.
One surprise: Retail clinics had the lowest rate for these antibiotic-inappropriate diagnoses, at 14 percent. Researchers said the proper use of antibiotics has been a focus of large retail clinic chains and could account for the lower percentage.