New research shows that parts of the U.S., in particular the Southeast, show patterns of outpatient antibiotic overuse. According to Extending the Cure, a project of the Center for Disease Dynamics, Economics & Policy this problem could intensify the rate at which these powerful drugs become useless.

The findings coincide with the start of the Centers for Disease Control and Prevention (CDC) initiative called “Get Smart: Know When Antibiotics Work”, which is an annual effort to decrease overuse of antibiotics that lasts throughout the week urging Americans to use antibiotics wisely. According to the CDC’s estimation each year $1.1 billion is spent on unnecessary antibiotic prescriptions just for adult upper respiratory infections alone. These prescriptions also accelerate the development of resistance to important antibiotic therapies.

This week, Extending the Cure introduced a new tool, the new Drug Resistance Index (DRI), allowing non-experts to track changes in antibiotic effectiveness over time. A paper of the British Medical Journal Open describes the new DRI, which is comparable with the Consumer Price Index concept.

Extending the Cure has released interactive maps, called ResistanceMap, where antibiotic consumption in the U.S. from 1999 to 2007 can be tracked and display the overall decrease in antibiotic dispensing, i.e. 12% over this time period. Despite this decrease, these images highlight an alarming trend in high antibiotic use across the Southeast compared with Pacific Northwest states. In areas where antibiotic rates are at their highest, like Kentucky and West Virginia for example, residents are seen to take almost double as many antibiotics per capita compared with those living in Alaska and Oregon.

Other key findings of the study show that the highest antibiotic use in the U.S. are Alabama, Louisiana, Kentucky, Tennessee and West Virginia, although the maps also display higher than average antibiotics use in other regions of the country. Antibiotic use per state can be seen at ResistanceMap.

From 1999 to 2007 prescriptions have soared up by 49% for a powerful class of antibiotics known as fluoroquinolones. Simultaneously, antibiotic resistance is on the increase, for example compared to 1999, these drugs currently tend to be seven times less effective against Escherichia coli, the most frequent cause of bacterial infections.

The number one of the antibiotics ‘hit list’ still remains to be penicillin, which accounts for almost one out of three prescriptions in the United States. As physicians increasingly turn to more powerful antibiotics, the market share of these standard drugs has simultaneously dropped by 28%.

According to the study, high per capita antibiotic usage could be a sign of consumers mistakenly demanding antibiotics with physicians prescribing them for colds or the flu, even though these illnesses are caused by viruses and cannot be treated with these drugs. Additional research must be carried out to gain a better understanding of the driving factors behind antibiotic use.

Written by Petra Rattue