Drug 'over-use' common on all fronts
Unnecessary use in hospitals, communities, farms
Antibiotic "over-use" is rampant in hospitals, communities, and agriculture in the United States, the Institute of Medicine in Washington, DC recently reported.1 The amount of unnecessary antibiotic administration was estimated as follows for the three settings:
Hospitals: An estimated 190 million daily defined doses of antibiotics are prescribed annually, 25% to 45% of which are unnecessary.
Communities: Of the 145 million courses of therapy prescribed annually in community settings, 110 million courses are for outpatient use and 35 million for emergency department use. The IOM estimated that 20% to 50% of the antibiotics administered for community-acquired infections are unnecessary.
Agriculture: Of the approximately 50 million pounds of antibiotics produced in the United States annually, about half are used in animals for therapeutic purposes, disease prophylaxis, and growth promotion. Each year an estimated 147 pounds of antibiotics are used per acre of farmed salmon, and 40,000 to 50,000 pounds of antibiotic are sprayed on fruit trees for control of bacterial infections. As much of 40% to 80% of overall agricultural use may be unnecessary.
Reference
1. Institute of Medicine. Antimicrobial Resistance: Issues and Options. Washington, DC: National Academy Press; 1998.
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