Study finds stewardship needed to combat ED antibiotic overuse for older adults

Emergency department-focused outpatient antibiotic stewardship remains needed for older adults who receive antibiotics for acute respiratory tract infections in cases where practitioners should never prescribe them, research found. Published in the American Journal of Infection Control, the retrospective cohort study analyzed U.S. ED visits from January 2013 through December 2025 among adults aged 65 years or older with never-appropriate acute respiratory tract infection diagnoses. Among 838,929 ED encounters, antibiotic overuse occurred in 38.5% of cases, with greater incidences occurring in several southern, southeastern and southwestern states. While antibiotic overuse declined after the Centers for Disease Control and Prevention published outpatient stewardship guidelines in 2016, rates gradually increased after the pandemic. Antibiotic overuse in older adults can lead to adverse drug events and Clostridoides difficile infections. (American Journal of Infection Control article, 7/31/26)