We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Commentary |

Tipping the Balance Toward Fewer Antibiotics ONLINE FIRST

Ateev Mehrotra, MD, MPH1,2; Jeffrey A. Linder, MD, MPH1,3
[+] Author Affiliations
1Harvard Medical School, Boston, Massachusetts
2Division of General Internal Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts
3Division of General Internal Medicine and Primary Care, Brigham & Women’s Hospital, Boston, Massachusetts
JAMA Intern Med. Published online September 19, 2016. doi:10.1001/jamainternmed.2016.6254
Text Size: A A A
Published online


News of patients with broadly resistant “superbugs” have recently raised public awareness of the risks of antibiotic overuse. But unnecessary antibiotic use is not a new problem; it has been a public health priority for decades and 2 new articles1,2 in the current issue of JAMA Internal Medicine illustrate the persistence of this problem. A number of initiatives have been attempted to address antibiotic overuse, and there was initial success with a roughly 20% reduction in outpatient antibiotic prescribing per capita.3 But those efforts have stalled, rates of outpatient antibiotic prescribing have remained stagnant, and, most troubling, an increasing fraction of prescriptions are for broad-spectrum antibiotics. The reality is that in the outpatient setting at least one-third of all antibiotics are prescribed unnecessarily.4 In hospitals there are similar trends. Baggs and colleagues1 found that the use of antibiotics per hospital day did not change between 2006 and 2012 and that the use of broad-spectrum antibiotics increased.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
The challenges of multi-drug-resistance in hepatology. J Hepatol Published online Aug 17, 2016;
[Surveillance of antibiotic consumption- a new task for public health services : Data from Frankfurt's hospitals between 2012 and 2014]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz Published online Sep 7, 2016;

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Evidence to Support the Update

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Evidence Summary and Review 1