Recent data shows that misdiagnoses and diagnostic errors have led to a higher risk of incorrect antibiotic use, which compromises antimicrobial effectiveness, the patient’s outcomes and the costs of health care.
The researchers gathered data from the Minneapolis Veterans Affairs Medical Center (MCAMC) that amounted to 500 inpatient cases. The analysts inspected provider diagnoses, which were labeled as correct, indeterminate, incorrect or a symptom correlating to an infectious disease but not a specific disease. The analysts then determined whether the antibiotic prescription was a correct match for the diagnosis.
"Antibiotic therapies are used for approximately 56 percent of inpatients in U.S. hospitals, but are found to be inappropriate in nearly half of these cases, and many of these failures are connected with inaccurate diagnoses," study lead author Greg Filice said. "The findings suggest that antimicrobial stewardship programs could be more impactful if they were designed to help providers make accurate initial diagnoses and to know when antibiotics can be safely withheld."
Ninety-five percent of the patients who had an incorrect or indeterminate diagnosis or a symptom identified without a diagnosis were prescribed wrong antibiotics. Just 38 percent of patients with correct diagnoses received wrong antibiotics. Overall, just 58 percent of patients had correct diagnoses, most commonly urinary tract infections, cystitis, pneumonia, urosepsis and kidney infections.
"Diagnostic accuracy is integral to the safe use of antibiotics,” Filice said. “In order to improve the use of antibiotics in healthcare, we must consider this challenge and look for tools and strategies that help clinicians decrease unnecessary and potentially harmful antibiotic use.”
Further details from the study are available online in Infection Control & Hospital Epidemiology, the journal of Society for Healthcare Epidemiology of America.