Antibiotic Use

What You Can Do

Your doctor can decide the best treatment when you're sick. An antibiotic may not be the best treatment. Sometimes, the best treatment may be over-the-counter medication, or lots of rest and drinking plenty of fluids. Ask your doctor or pharmacist about ways to feel better. Respiratory viruses usually go away on their own in a week or two.

If you are prescribed antibiotics, it’s important to take them exactly as instructed by your doctor. This will fully treat the bacterial infection and lower the risk of developing antibiotic-resistant bacteria. Talk to your provider if you have side effects or allergic reactions while taking an antibiotic. Don't share antibiotics with others or save them for later.

Information for Health Care Professionals

Unnecessary or partial antibiotic use can lead to antibiotic-resistant infections and other health issues for patients, like C. difficile infections, allergic reactions, and side effects. The Centers for Disease Control and Prevention (CDC) estimates that at least 30% of antibiotics prescribed in the outpatient setting are unnecessary, meaning that no antibiotic was needed. 

Health care professionals play a vital role in addressing the threat of antibiotic resistance. Learn more about U.S. and Vermont prescribing data and get tips for talking to your patients about the benefits and harms of antibiotics.

Antibiotic Prescribing Data

According to the 2022 Centers for Disease Control and Prevention Outpatient antibiotic prescription data, U.S. health care professionals prescribed 236.4 million antibiotic prescriptions—equivalent to 709 antibiotic prescriptions per 1,000 people.

Other CDC data highlights from 2022:

• Vermont ranks 23 out of 50 U.S. states in antibiotic prescription rates per 1,000 people.
• The Northeast antibiotic prescription rate (per 1,000 people) is lower than in the South but higher than in the West and Midwest. 
• Dermatology, emergency medicine, physician assistants and nurse practitioners, and primary care physicians had the highest antibiotic prescription rates in the U.S. 
• U.S. adults ages 20 and older had higher prescribing rates compared to people under 20. 
• Women were more likely to be prescribed antibiotics compared to men in the U.S.

More on measuring outpatient antibiotic prescribing (CDC)

What Providers Can Do

Deciding whether to prescribe antibiotics can be complex. Physicians must weigh medical information with patient satisfaction and expectations, time constraints, decision fatigue, and uncertain diagnoses inherent in medical decision-making. 

You might feel pressure to prescribe antibiotics for viral illnesses that can’t be treated with these medications. To manage patient expectations effectively, it's important to share both the benefits and risks of antibiotic use and alternative strategies for feeling better when antibiotics are not the solution. Try these approaches:

• Explain why antibiotics are not needed. Share how antibiotics do not work on viral illnesses and the risks of taking antibiotics when they aren’t needed, including antibiotic-resistant infections, allergic reactions, C.diff infections, and side effects.
• Provide positive treatment recommendations. Studies have found that patients are more willing to accept that antibiotics are not needed if the message is combined with how to help them feel better with at-home strategies or over-the-counter medicines.
• Come up with a backup plan together. Advise the patient to follow up with you after a certain number of days if their symptoms aren’t better or if symptoms get worse. You may reassess at that time if antibiotics are needed. 
• Consider delayed antibiotic prescriptions. When it’s difficult to know whether an illness is viral or bacterial, counsel your patient on waiting for a certain amount of time to see if their illness clears up on its own before filling a prescription for antibiotics.

Get more tips from the American Family Physician Journal

Penicillin Allergies

• About 10% of U.S. patients report having an allergic reaction to penicillin in their past. However, less than 1% of the population have a true penicillin allergy.

• Conduct a history and physical exam to confirm a true penicillin allergy (and when appropriate, skin test and challenge dose) before prescribing broad-spectrum antibiotics to a patient thought to be penicillin allergic.
   

  Learn more about the clinical features of penicillin allergies and how to talk to your patients about it from the CDC
   

  CDC Factsheet: Is it really a penicillin allergy?