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MRSA causing antibiotic over prescribing

A New York Medical College study suggests that MRSA medical liability concerns may be a factor in clinicians prescribing antibiotics more often and more broadly than warranted

A New York Medical College study suggests that MRSA medical liability concerns may be a factor in clinicians prescribing antibiotics more often and more broadly than clinical circumstances and evidence-based guidelines warrant.

The team analysed census figures, statistics on population density of attorneys and physicians, and data on antibiotic utilisation for the United States, Canada, and 15 European countries. They compared this to statistics on the percentage of methicillin-resistance among clinical isolates of S. aureus. They found a strong correlation between the prevalence of methicillin-resistance and density of attorneys in countries in Europe and North America. They found no correlation between prevalence of methicillin-resistance and physician density.

Investigators surveyed 162 healthcare providers to determine whether medical liability concerns were as important as antibiotic cost and formulary restrictions in selecting treatment regimens. The surveys also confirmed that physicians were more concerned about medical liability in cases of under-prescribing antibiotics rather than by over-prescribing them.

Dr George Sakoulas, assistant professor of medicine and lead author of the study, concluded: "The findings suggest that more research is needed to evaluate the potential impact of medical liability concerns on the medical care system. The study findings hint toward the importance of medical tort reform as a way to reduce healthcare costs and improve quality. Another way might be to foster more judicious prescription of antibiotics based on science and evidence rather than on risk aversion."

The study appeared in the September-October issue of the American Journal of Therapeutics

21st December 2009

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