The prescribing of antibiotics has dropped significantly in the Triad and North Carolina in the past six years, according to a study released Thursday by the Blue Cross Blue Shield Association.

Both the region and state remain at the national average in usage as well.

The Blue Cross association conducted the study in partnership with HealthCore and Blue Health Intelligence. The goal was examining antibiotic prescriptions filled by commercially insured members as a result of an outpatient visit from 2010 to 2016.

The scope of the research was 173 million claims for filled antibiotic prescriptions from more than 31 million commercially-insured Americans under age 65.

“The overuse of antibiotics, which is known to cause antibiotic-resistant bacteria, has been a topic of concern among health-care professionals and policy makers in America for many years,” the Blue Cross association said.

“These resistant bacteria are immune to common medications and are difficult to treat.”

The Triad had a 16 percent decline — to 71.7 out of every 100 members — in the number of antibiotic prescriptions filled. The national rate dropped from 90.7 per 100 members to 82.6.

In the category of broad-spectrum antibiotics, there was an 18 percent decline to 37.3 per 100 members, compared with a 13 percent decline nationally to 43.7 per 100. Broad-spectrum antibiotics are the type most likely to facilitate the creation of antibiotic-resistant bacteria.

In the pediatric category, there was a 24 percent decline in the Triad to 65.6 per 100, compared with a 16 percent nationally to 80.8 per 100.

The researchers said both the regional and national decrease in antibiotic use “indicates that considerable progress is being made in public health campaigns to limit the use of antibiotics and prevent the development of antibiotic-resistant bacteria.”

Cone Health, Novant and Wake Forest Baptist Medical Center have antimicrobial/antibiotics stewardship initiatives aimed at supporting best practices for antibiotic use and improving clinical outcomes for patients.

Lisa Blanchette, system manager for Novant Health Inc.’s antimicrobial stewardship program, said in a statement that “antibiotics are valuable and life-saving medications for treating patients with bacterial infections.

“But for patients with viral infections, such as the common cold, flu and most cases of sore throat, antibiotics can do more harm than good.”

Blanchette said Novant is “continually educating both team members and patients about the risks of antibiotic use, including antibiotic resistance, side effects and allergic reactions.”

Dr. Gary Rosenthal, chairman of Wake Forest Baptist Medical Center’s internal medicine department, said the antibiotic resistance issue “has been brewing for several decades, and there has been building a greater awareness of antibiotic resistance.”

“If you can cut down the use of antibiotics for patients who won’t benefit from it, it can help resolve the problem.”

Rosenthal said that while “the overall report is good news, there’s still more work to be done.

“What the study doesn’t tell you are whether the antibiotic was appropriate for the patient, and then did we select the right antibiotic.”

Dr. Bruce Swords, Cone’s chief medical officer, said “patient education is a powerful tool” in the role it has played in reducing unnecessary antibiotic use.

“Cone Health Medical Group providers and community physicians in our Triad HealthCare Network have been especially effective in helping patients understand that antibiotics aren’t always needed, Swords said.

Study researchers determined that “wide regional variation in antibiotic prescription fill rates exists, with the highest-prescribing states filling nearly three times as many prescriptions per person as the lowest-prescribing states.”

“Portions of Appalachia and the South have the highest prescription fill rates, while prescription fill rates in rural areas are 16 percent higher than in urban areas.”

Researchers also found that in 2016, health-care professionals prescribed antibiotics in more than 20 percent of outpatient visits where their use is not indicated to treat the condition.

“The data also show large regional variation in the prescribing of antibiotics and continued high use for conditions where antibiotics have limited effectiveness, indicating there are further improvements to be made,” the researchers said.

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