Shocking Figures on Misdiagnoses and Incorrect Antibiotic Prescriptions

Antibiotic resistance is a worldwide threat with potentially disastrous consequences. In the wake of a recent report claiming Salmonella is becoming less sensitive to medication, a new study shows how misdiagnoses are contributing to the growing problem.

Researchers from the Society for Healthcare Epidemiology of America identified unsettling patterns of errors that lead to unnecessary antibiotic prescriptions. Lead author Greg Filice, MD, and his colleagues analyzed 500 cases from the Minneapolis Veterans Affairs Medical Center to determine the noteworthy report.

“Antibiotic therapies are used for approximately 56 percent of inpatients in US hospitals, but are found to be inappropriate in nearly half of these cases,” Filice explained in a news release.

The team organized the hundreds of reports into one of the 4 categories: correct, incorrect, indeterminate, or showed a symptom linked to an infectious disease instead of a specific syndrome or disease. It was also decided if the course of treatment was appropriate for the diagnosis or lack thereof.

Published in Infection Control & Hospital Epidemiology, it was determined that out of the 500 cases, 291 (58%) were correct, 156 (31%) were incorrect, 22 (4%) were indeterminate, and 31 (6%) showed a symptom linked to an infectious disease.

Filice said that “many of these failure are connected with inaccurate diagnoses” with pneumonia, cystitis, urinary tract infections, kidney infections, and urosepsis being the most common.

So what’s causing the abundance of misdiagnoses? The statement pinpoints issues that healthcare workers (HCWs) have which aid the blunders:

• HCWs follow intuitive processes instead of analytical ones (which are more reliable)
• HCWs experience fatigue, sleep deprivation, and/or cognitive overload
• HCWs treat patients who already received a diagnosis from another clinician
• Lack of clinical experience and knowledge of drug effects

Looking at the bigger picture, these inaccuracies help promote the antibiotic resistance epidemic. However, they are certainly damaging on a personal level for patients. Whether it takes longer to cure the real problem or giving them antibiotics that their bodies don’t need, each mistake makes an impact.

The study concluded with the researchers stressing the importance of accurate diagnoses to avoid unnecessary prescribing.

“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,” Filice said.