title: Topical antibiotic trends from 1993 to 2007: use of topical antibiotics for non-evidence-based indications.
abstract: BACKGROUND
  Systemic antibiotic use has become more conservative with the emergence of drug resistance. Topical antibiotics are employed for a variety of indications, although there are only a few evidence-based indications.
  
  
  OBJECTIVE
  To examine topical antibiotics use in the outpatient setting.
  
  
  METHODS
  Topical antibiotic use was characterized using data from the 1993 to 2007 National Ambulatory Medical Care Survey. Visits were identified at which a topical antibiotic was used and analyzed according to patient demographics, diagnoses, procedures, concomitant medications, and provider specialty. Topical antibiotic use over time was analyzed using linear regression.
  
  
  RESULTS
  The most frequent diagnoses associated with topical antibiotic use were benign or malignant neoplasm of skin, impetigo, insect bite, and cellulitis. Data revealed a significant downward trend in topical antibiotics associated with dermatologic surgery (p<.001) and a nonsignificant downward trend in use in conjunction with skin biopsies (p=.09). Topical antibiotic use by dermatologists was noted to be decreasing over time, whereas among non dermatologists, it was noted to be increasing, although neither of these trends was statistically significant.
  
  
  CONCLUSIONS
  Topical antibiotics continue to be used for non-evidence-based indications, despite data that suggest that such use may be detrimental for patients and represents significant costs to the health care system. The authors have indicated no significant interest with commercial supporters.
authors: Department of Dermatology, Center for Dermatology Research, School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.
authors: Whitney J
authors: WJ
authors: Lapolla
authors: Michelle M
authors: MM
authors: Levender
authors: Scott A
authors: SA
authors: Davis
authors: Brad A
authors: BA
authors: Yentzer
authors: Phillip M
authors: PM
authors: Williford
authors: Steven R
authors: SR
authors: Feldman
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003880:Dermatology / Q000706:statistics & numerical data; D004363:Drug Utilization; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012871:Skin Diseases / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents