Outpatient Antibiotic Prescriptions — United States, 2020

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Citation: Centers for Disease Control and Prevention. Outpatient antibiotic prescriptions — United States, 2020.

Data Sources:

Systemic oral antibiotics were extracted from the IQVIA Xponent database. IQVIA captured an estimated 92% of outpatient prescriptions dispensed from retail pharmacies for any medication nationally, reconciled them to wholesale deliveries to these pharmacies, and projected to 100% coverage. These data represent all outpatient antibiotic prescriptions from community pharmacies from all payers but exclude federal facilities. Provider specialties are taken from the American Medical Association (AMA) self-designated practice specialties, DEA and NPI sources and categorized into one of 17 groups. Population data were obtained from the U.S. Census bridging files.

Total outpatient oral antibiotic prescriptions in 2020

 

Healthcare providers prescribed 201.9 million antibiotic prescriptions—equivalent to 613 antibiotic prescriptions per 1000 persons.

Table 1. Oral antibiotic prescriptions by age, sex, and region—United States, 2020

For each age group, number of prescriptions and rate per 1,000
Age groupa NUMBER OF ANTIBIOTIC PRESCRIPTIONS (MILLIONS) ANTIBIOTIC PRESCRIPTIONS PER 1,000 PERSONS, RATE
<20 33.3 389
>=20 168.4 690
For each sex, number of prescriptions and rate per 1,000
Sexa NUMBER OF ANTIBIOTIC PRESCRIPTIONS (MILLIONS) ANTIBIOTIC PRESCRIPTIONS PER 1,000 PERSONS, RATE
Male 76.8 473
Female 125 747
For each region, number of prescriptions and rate per 1,000
Regiona NUMBER OF ANTIBIOTIC PRESCRIPTIONS (MILLIONS) ANTIBIOTIC PRESCRIPTIONS PER 1,000 PERSONS, RATE
Northeast 35.5 636
Midwest 42.8 627
South 88.5 698
West 34.9 444

aTotals may not add to all oral prescriptions (201.9 million) due to missing data

Table 2. Top oral antibiotic classes and agents—United States, 2020

For each antibiotic class, number of prescriptions and rate per 1,000
ANTIBIOTIC CLASS NUMBER OF ANTIBIOTIC PRESCRIPTIONS (MILLIONS) ANTIBIOTIC PRESCRIPTIONS PER 1,000 PERSONS, RATE
Penicillins 43.2 131
Cephalosporins 30.2 92
Macrolides 29 88
Tetracycline 22.7 69
B-lactams, increased activity 21 64
For each antibiotic agent, number of prescriptions and rate per 1,000
ANTIBIOTIC AGENT NUMBER OF ANTIBIOTIC PRESCRIPTIONS (MILLIONS) ANTIBIOTIC PRESCRIPTIONS PER 1,000 PERSONS, RATE
Amoxicillin 39.3 119
Azithromycin 27.6 84
Amoxicillinclavulanic acid 21 64
Cephalexin 19.6 60
Doxycycline 19.5 59

Table 3. Oral antibiotic prescribing by provider specialty — United States, 2020

For each provider specialty, number of prescriptions and rate per provider
Provider Specialty NUMBER OF ANTIBIOTIC PRESCRIPTIONS (MILLIONS) ANTIBIOTIC PRESCRIPTIONS PER PROVIDER, RATE
Primary Care Physicians 64.1 270
Physician Assistants and Nurse Practitioners 62.3 360
Surgical Specialties 15.3 172
Dentistry 23.4 191
Emergency Medicine 9.5 295
Dermatology 5.6 496
Obstetrics/Gynecology 4.6 123
Other 17.0 82
All Providers 201.9 221

a Total may not add to all oral prescriptions (201.9 million) due to rounding.

Figure 1. Antibiotic prescriptions per 1000 persons by state (sextiles) for all ages — United States, 2020

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This project was made possible through a partnership with the CDC Foundation. Support for this project was provided by The Pew Charitable Trusts.

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Page last reviewed: October 18, 2021
Content source: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Healthcare Quality Promotion (DHQP)