NEW YORK Skyrocking rates of antibiotic prescriptions now suggest that as many as four out of five Americans may be getting antibiotics annually, according to a new study by the Centers for Disease Control and Prevention.
It's is concerning officials, especially because overuse is one reason antibiotics are losing their punch and making infections harder to treat.
"It sounds high," said Keith Rodvold, a professor of pharmacy practice at the University of Illinois at Chicago.
The report released Wednesday gives the first detailed look at usage of these medicines in every state and finds it highest in the South and Appalachia. West Virginia had the highest rates at 1.237 prescriptions per person, followed by Kentucky at 1.232 and Tennessee at 1.199. The lowest rates were found in California (0.6 per person), Oregon (0.595) and Alaska (0.529).
"Why is West Virginia more than double compared to Alaska? I imagine there are provider factors, patient factors and cultural factors that are all shaping the impact," study author Lauri Hicks, medical director of the U.S. Centers for Disease Control and Prevention, said to HealthDay.
There is no scientific consensus on an appropriate level of antibiotic prescribing. But some experts said the new study's results are disturbing, and that rates are probably excessive even in the states with the lowest antibiotic prescription levels.
Antibiotics have been commonly available since the 1940s, and have done wonders at saving patients with infections ranging from pneumonia to sexually spread diseases. But bacteria have increasingly gained the power to shrug off antibiotics.
Experts say chances of resistance increase when antibiotics are not used long enough or are taken for the wrong reasons, allowing bacteria to survive and adapt. The Centers for Disease control and Prevention is tracking at least 20 strains of resistant bacteria.
"There are infections out there that have become almost impossible to treat," Hicks said to HealthDay. "We really are on the verge of going down a path where there may be nothing that works. Now we're seeing young, healthy people getting these highly resistant infections requiring hospitalization where in the past a simple oral antibiotic would have taken care of it."
CDC researchers conducted the new study, analyzing a national prescription drug database for 2010. The findings are being published in Thursday's New England Journal of Medicine.
Other studies have focused on antibiotic prescriptions for specific groups like Medicare patients. This is the first to look at it for all Americans.
Doctors and other health care providers prescribed 258 million courses of antibiotics in 2010, for a population just shy of 309 million, the researchers found. That translates to 833 antibiotic prescriptions for every 1,000 people, on average. Prescriptions were most frequently written for children under 10 and adults 6 and older.
Rates in the South -- 936 prescriptions per 1,000 people -- were much higher than in the West -- 639 prescriptions per 1,000 people.
One reason for the difference in rates throughout the country may be Southerners suffer more infections than people in other parts of the country.
Southern states have the highest rates of obesity and diabetes, and diabetics tend to have more infections than other people, noted the CDC's Dr. Lauri Hicks, one of the study's authors.
"So some of that prescribing may be warranted," she said.
During the swine flu pandemic of 2009 and 2010, the South saw more reports of illness than other parts of the country. Experts at the time said patients with flu-related pneumonia should be treated with both antiviral medicines and antibiotics to prevent all forms of deadly complications, Rodvold noted.
The South also has higher rates of certain other respiratory infections, including bronchitis, according to a study last year by University of Pittsburgh researchers.
And the CDC study found the most frequently prescribed antibiotic was azithromycin, which is commonly used for bronchitis symptoms. But that's a problem. Bronchitis is usually caused by a virus, and antibiotics like azithromycin don't work against viruses.
"Some of the prescribing may not be warranted," Hicks said.