Significant numbers of U.S. patients with COVID-19 who were not sick enough to be hospitalized were inappropriately prescribed antibiotics or steroids in 2020 and 2021, according to two studies recently published in JAMA.
One study found that between April 2020 and April 2021, antibiotic prescriptions were written during 30% of outpatient visits for COVID-19 among Medicare beneficiaries, even though antibiotics kill bacteria, not viruses.
A separate study points out that while steroids are known to benefit severely ill hospitalized patients with COVID-19, the U.S. National Institutes of Health (NIH) advises against their use in patients with mild-to-moderate illness from the coronavirus.
Still, the researchers found, between April 2020 and August 2021, steroids – which can lead to a host of adverse side effects – were prescribed to 16.4% of 576,885 non hospitalized COVID-19 patients in a Medicare database and 9.4% of 766,105 such patients in a database maintained by the U.S. Food and Drug Administration.
The prescriptions appeared to be more prominent in the South. In both databases, the use of steroids rose steadily over time.
“Given the increasing use of corticosteroids through August 2021, the potential (danger)…and the lack of efficacy data in patients with mild to moderate COVID-19, it is critical that prescribers consider the NIH guidelines in the therapeutic management of nonhospitalized patients with COVID-19,” the authors of the steroid study said.