Outpatient Antibiotic Prescriptions — United States, 2019

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Citation: Centers for Disease Control and Prevention. Outpatient antibiotic prescriptions — United States, 2019.

Data Sources:

Systemic oral antibiotics were extracted from the IQVIA Xponent database. IQVIA captured an estimated 92% of outpatient prescriptions dispensed* from retail pharmacies for any medication nationally, reconciled them to wholesale deliveries to these pharmacies, and projected to 100% coverage. These data represent all outpatient antibiotic prescriptions from community pharmacies from all payers but exclude federal facilities. Provider specialties are taken from the American Medical Association (AMA) self-designated practice specialties, DEA and NPI sources and categorized into one of 17 groups. Population data were obtained from the U.S. Census bridging files.

*Note: In 2017, IQVIA revised and enhanced their methodology to account for prescriptions not picked up, returned, or re-stocked. These situations may have led to overstated prescriptions and makes the revised methodology data more accurate. Previous methodology data should not be directly compared to revised methodology. Data using both revised and previous methodology data are available in the 2017 and 2018 Annual Reports, however only revised data is available for 2019 onward.

Total outpatient oral antibiotic prescriptions in 2019

 

Healthcare providers prescribed 251.1 million antibiotic prescriptions—equivalent to 765 antibiotic prescriptions per 1000 persons.

Table 1. Oral antibiotic prescriptions by age, sex and region—United States, 2019

For each age group, number of prescriptions and rate per 1,000
Age groupa NUMBER OF ANTIBIOTIC PRESCRIPTIONS (MILLIONS) ANTIBIOTIC PRESCRIPTIONS PER 1,000 PERSONS, RATE
<20 55.8 650
>=20 194.8 804
For each sex, number of prescriptions and rate per 1,000
Sexa NUMBER OF ANTIBIOTIC PRESCRIPTIONS (MILLIONS) ANTIBIOTIC PRESCRIPTIONS PER 1,000 PERSONS, RATE
Male 97.9 606
Female 152.8 917
For each region, number of prescriptions and rate per 1,000
Regiona NUMBER OF ANTIBIOTIC PRESCRIPTIONS (MILLIONS) ANTIBIOTIC PRESCRIPTIONS PER 1,000 PERSONS, RATE
Northeast 45.1 806
Midwest 53.8 788
South 108.9 867
West 43 549

aTotals may not add to all oral prescriptions (251.1 million) due to missing data


Table 2. Top oral antibiotic classes and agents prescribed—United States, 2019

For each antibiotic class, number of prescriptions and rate per 1,000
ANTIBIOTIC CLASS NUMBER OF ANTIBIOTIC PRESCRIPTIONS (MILLIONS) ANTIBIOTIC PRESCRIPTIONS PER 1,000 PERSONS, RATE
Penicillins 58.8 179
Macrolides 39.8 121
Cephalosporins 37.1 113
B-lactams, increased activity 28.4 87
Tetracycline 24.9 76
For each antibiotic agent, number of prescriptions and rate per 1,000
ANTIBIOTIC AGENT NUMBER OF ANTIBIOTIC PRESCRIPTIONS (MILLIONS) ANTIBIOTIC PRESCRIPTIONS PER 1,000 PERSONS, RATE
Amoxicillin 54.1 165
Azithromycin 37.9 115
Amoxicillin\clavulanic acid 28.4 87
Cephalexin 21.7 66
Doxycycline 21.3 65

Table 3. Oral antibiotic prescriptions by provider specialty — United States, 2019

For each provider specialty, number of prescriptions and rate per provider
Provider Specialty NUMBER OF ANTIBIOTIC PRESCRIPTIONS (MILLIONS) ANTIBIOTIC PRESCRIPTIONS PER PROVIDER, RATE
Primary Care Physicians 85.9 362
Physician Assistants and Nurse Practitioners 80.8 466
Surgical Specialties 17.2 192
Dentistry 24.7 201
Emergency Medicine 12.5 386
Dermatology 5.8 514
Obstetrics/Gynecology 4.9 130
Other 19.2 92
All Providers 251.0 275

aTotals may not add to all oral prescriptions (251.1 million) due to missing data


Figure 1. Antibiotic prescriptions per 1000 persons by state (sextiles) for all ages — United States, 2019

This project was made possible through a partnership with the CDC Foundation. Support for this project was provided by The Pew Charitable Trusts.