Prescribing antibiotics was associated more often with malpractice claims than failure or delay to prescribe antibiotics, according to the authors of a recent analysis.1
“These findings may be surprising to clinicians who tend to err on the side of prescribing an antibiotic when there is an uncertain diagnosis and the patient is not very ill,” says Sarah Kabbani, MD, MSc, the study’s lead author and medical officer at the CDC’s Antibiotic Stewardship Office.
Researchers analyzed 767 antibiotic-related malpractice lawsuits from 2007 to 2016. About 11% of these claims involved the ED. “Fear of medical liability is often cited by clinicians as a cause for unnecessary or inappropriate antibiotic prescribing,” Kabbani reports.
However, evidence on actual legal risks of failing to give antibiotics is lacking. Part of the problem is that both clinicians and patients frequently believe that taking an antibiotic is the safest practice in cases where it is unclear if antibiotics are needed.
“Recent data describing a high frequency of adverse events and side effects associated with taking antibiotics call this belief into question,” Kabbani says. Poor communication with patients was a top contributing factor in the malpractice claims.
Kabbani says that to reduce risks of antibiotic prescribing, ED providers should carefully weigh the risks and benefits of prescribing antibiotics. They should communicate effectively with the patients and their families about antibiotic use, and ensure monitoring and follow-up of hospitalized patients on antibiotics. “This is important to ensure that patients receive the right drug, the right dose, and the right duration,” Kabbani adds.
- Kabbani S, Greenberg P, Falcone B, et al. Analysis of antibiotic-related malpractice claims, 2007 to 2016. Open Forum Infect Dis 2019;6:S596.