Diagnostic Errors Lead to Inappropriate Antimicrobial Use

The scientists found that 95% of patients with an incorrect or indeterminate diagnosis, or with a symptom identified but no diagnoses made, were given inappropriate antibiotics. By comparison, only 38% of patients who received a correct diagnosis were incorrectly given antibiotics. The inappropriate use of antibiotics contributes to antibiotic resistance, clinical failure, adverse drug events, and excessive costs. Additionally, they found that overall, only 58% of patients received a correct diagnosis, indicating that diagnostic errors were more prevalent in their study than in previous studies unrelated to antimicrobial use. The most common incorrect diagnoses identified by the specialists were pneumonia, cystitis, urinary tract infections, kidney infections and urosepsis.

The authors concluded that the impact of diagnostic accuracy on the appropriateness of antimicrobial therapy and they provide a detailed analysis of types and predictors of diagnostic errors and their relationship to types of inappropriate antimicrobial use. These findings suggest that more studies are needed to elucidate mechanisms of diagnostic errors related to antimicrobial prescribing. They also suggest that antimicrobial stewardship programs could increase their impact if they were designed to help providers make accurate initial diagnoses and to help providers know when antimicrobial therapy can be safely withheld.

Gregory A. Filice, MD, lead author of the study, said, “Diagnostic accuracy is integral to the safe use of antibiotics. 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.” The study was published on May 18, 2015, in the journal Infection Control & Hospital Epidemiology

Related Links:.
Minneapolis Veterans Affairs Health Care System