Assessment of High-Volume Antibiotic and Opioid Prescribing by Medicare Part D Prescribers―United States, 2021

Characterizing high-volume co-prescribing of antibiotics and opioids can inform interventions that improve prescribing practices. Using 2021 Medicare Part D data, we conducted a cross-sectional analysis to assess concordance between high-volume prescribing of antibiotics and opioids and characterize associations between prescriber-level factors and high-volume co-prescribing of antibiotics and opioids. High-volume antibiotic prescribers accounted for 12.5 million (36.0%) antibiotic prescriptions, and high-volume opioid prescribers accounted for 22.3 million (51.9%) opioid prescriptions. We found fair concordance between being a high-volume prescriber of antibiotics and a high-volume prescriber of opioids (κ = 0.30). Prescribers in the South (adjusted odds ratio [AOR] = 3.67; 95% CI, 3.46-3.90) and in rural areas (AOR = 2.32; 95% CI, 2.12-2.54) were more likely to be high-volume co-prescribers of antibiotics and opioids than prescribers in the West and in urban areas, respectively. Public health and professional organizations can partner to provide support to optimize antibiotic and opioid prescribing practices and improve patient safety.