CHICAGO — As antibiotic resistance poses a growing threat to public health across the globe, new research published today from the American Medical Association (AMA) and The Pew Charitable Trusts (Pew) highlights the need for improved antibiotic stewardship in outpatient settings to combat antibiotic resistance. The organizations commissioned a joint study of 1,550 primary care physicians in the U.S. that identified barriers to reducing unnecessary antibiotic prescribing in outpatient settings and emphasized the need for physician and patient education to prevent the acceleration of antibiotic resistant infections.

Published today in the journal Open Forum Infectious Diseases, the study revealed that while 94% of primary care physicians agree antibiotic resistance is a problem in the U.S., 55% do not find it to be an area of concern in their own practices, ranking it as less important than other public health issues like obesity, diabetes, opioids, smoking, and vaccine hesitancy. Additionally, 91% of respondents indicated they believe stewardship programs are appropriate for office-based practices, but many said patients and families should be the primary focus of stewardship efforts. Approximately half of participants felt that tracking appropriate antibiotic use would be difficult to do in an accurate and fair manner and that antibiotic use reporting would be a significant burden for their practice.

“Antibiotic resistance is an impending public health crisis. We are seeing today, as we respond to the COVID-19 pandemic, what our health system looks like with no or limited treatments available to tackle an outbreak. To stem the rise of antibiotic resistant infections, we must all remain vigilant in combatting the spread of antibiotic resistant bacteria and be prudent when prescribing antibiotics,” said AMA President Susan R. Bailey, M.D. “The AMA encourages physicians to prioritize antibiotic stewardship programs in their practices to ensure the appropriate use of antibiotics and improve patient and public health outcomes.”

The AMA and Pew also conducted focus groups with primary care physicians in Chicago, Los Angeles, Philadelphia, and Birmingham, Alabama to gauge physician perceptions about antibiotic resistance, outpatient antibiotic stewardship approaches and inappropriate prescribing to better understand the barriers to effective stewardship. A study highlighting the findings from the focus groups was published in the peer-reviewed journal BMJ Open in July. While findings suggest support for education-focused stewardship activities, respondents expressed skepticism around the utility of antibiotic use tracking and reporting as a stewardship strategy. The study findings provide important insights on physician perceptions about antibiotic stewardship that should be considered by stakeholders when implementing interventions aimed at improving antibiotic prescribing habits.  

The AMA has long supported efforts to prevent the spread of drug-resistant organisms in health care facilities and communities. Specifically, the AMA has adopted numerous policies and advocated for legislation over the years supporting efforts to address antibiotic resistance, including reducing barriers to antibiotic development through incentives. Because antibiotics are important in the treatment of human infections, existing AMA policy also calls for continued education on appropriate antibiotic use as well as bringing an end to the practice of using medically-important antibiotics for growth promotion in animals. 

As part of its efforts to combat the spread of antibiotic resistant infections, the AMA Ed Hub^TM contains a collection of educational resources for physicians focused on antibiotic use, resistance, and stewardship.