The prevailing practice in many hospitals is to give immediate, often broad-spectrum, antibiotics to all hospitalized patients with possible infections. Two interlinked factors drive this practice: (1) clinicians fear that any delay in appropriate antibiotics may increase patients’ risk for worse outcomes including death, and (2) it is uncomfortable to withhold antibiotics from a patient who may have an infection, even if the likelihood of infection is low; doing something feels more responsive, responsible, and patient-centric than doing nothing. The net result, however, is widespread use of antibiotics, much of which is unnecessary. Overprescribing is particularly pronounced in patients with pneumonia. Study after study has documented high rates of pneumonia overdiagnosis, suggesting a rush to treat despite equivocal evidence of disease. Up to half of hospitalized patients treated for pneumonia may not actually have pneumonia.1,2
Klompas M. Overuse of Broad-Spectrum Antibiotics for Pneumonia. JAMA Intern Med. 2020;180(4):485–486. doi:10.1001/jamainternmed.2019.7251
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