Overuse of Empirical Antibiotics for Acute Diarrhea

Examination of Medicaid data from Tennessee revealed that antimicrobials were prescribed for more than 10% of diarrhea episodes, usually without a stool culture.

Antimicrobial therapy is rarely indicated for acute diarrhea, and current guidelines recommend that a stool culture be performed when such therapy is prescribed. Investigators recently examined Medicaid data from Tennessee for 1995 through 2004 to determine the frequency of antimicrobial use for acute diarrhea and the extent to which stool cultures accompanied such therapy.

Of 315,828 diarrheal episodes identified, 15,820 (5.0%) were evaluated with stool culture, and 32,949 (10.4%) were treated with antimicrobial therapy. Among the episodes for which antimicrobial therapy was prescribed, only 3504 (10.6%) had a stool culture performed. Multivariable regression revealed that white race, urban residence, antimicrobial prescription, and not rec…

Reviewing Author

Daniel J. Diekema, MD, MS