Is 45% of Antibiotic Scripts Illegitimate? - SpecialtyRx
March 11, 2020
Is 45% of Antibiotic Scripts Illegitimate?

Research shows 1 in 5 antibiotic prescriptions have ‘no clear rationale’

Why Medicaid needs to crack down on indiscriminate doctors

A study published by Northwestern University reveals a disturbing trend among U.S. Medicaid patients. Aſter examining numerous claims, researchers determined that roughly 45% of all antibiotics were prescribed without adequate diagnosis or explanation.
With antibiotic stewardship programs a hallmark of long-term care organizations, the news is troubling—but not necessarily surprising. Operators are always looking for ways to better prevent and treat bacterial infection. But when antibiotics are used improperly, patients can experience dangerous (sometimes deadly) side effects. Not to mention, providers contribute to the growing problem of antibiotic resistance.


Getting Rx on track

Upon announcement of their findings, study contributors emphasized a key takeaway. In order to ensure their antibiotic stewardship programs are effective, Medicaid providers must first crack down on prescriptions being written over the phone, via email, through online portals or during uncaptured visits.
Over a quarter of bad prescriptions were written without an actual office visit. And of those patients that did have an appointment with the doctor, 17% received an antibiotic prescription without an infection-related diagnosis. Overall, the study estimates that stewardship policies miss about 45% of inappropriate prescriptions.
“It’s concerning that nearly half of antibiotics are prescribed without a visit or without a clear rationale,” says Dr. Jeffrey Linder, senior author of the study. “We are not keeping track of and do not have a system to ensure high-quality antibiotic prescribing in the U.S.”
Northwestern Now reporter Kristin Samuelson adds that “prior to this study, antibiotic prescribing for Medicaid patients in the U.S. had not been comprehensively measured.” The findings have sent shockwaves throughout the industry, inspiring Medicaid providers to evaluate their own methods of antibiotic stewardship.

So, what does SpecialtyRx recommend?


  1. We remind our partners to commit to meticulous recordkeeping.
  2. From there, continue to educate patients and caregivers on proper antibiotic use.
  3. And finally, keep in mind the CDC’s three ‘types’ of stewardship interventions, and seek to adopt them in whatever ways possible: broad; pharmacy-driven; and infection and syndrome specific.