Antimicrobial resistance is the ability of a microbe to resist the effects of an antimicrobials. According to the CDC, every year, more than two million people in the United States get infections that are resistant to antibiotics and at least 23,000 people die as a result. Antibiotic resistance adds $20 billion in excess direct health care costs, with additional costs to society for lost productivity as high as $35 billion a year. Up to 50 percent of all the antibiotics prescribed for people are not needed or are not prescribed appropriately.
De identified data about the number of board certified Infectious Diseases (ID) physicians by zip code was obtained from the Doximity physician database. The location of current ID fellowships was obtained from the NRMP public data. These were mapped using Google fusion tables and the results compared to several CDC databases, mainly: percent of hospitals with antimicrobial stewardship programs (ASPs) and number of antibiotic prescriptions by providers in the country.
A total of 147 fellowship programs and 7129 board certified ID physicians were identified. Percent of hospitals with ASPs were the least in the North and South of the country which correlated well with higher number of antibiotics prescribed by providers, especially in the Southern belt. These locations also correlated with fewer fellowships and board certified physicians. These physicians tend to have a heavy concentration in the Eastern and Western belt of the country which correlated well with a higher prevalence of ASPs.
The use of this novel social network mapping approach to assess the ID physician workforce has the potential of providing real time data regarding their geographical spread. ASPs have a higher prevalence along the belts that correlate well with the spread of the ID work force. Antibiotic resistance being a problem of such massive implications, a consideration could be made to address the discrepancies between the prevalence of these stewardship programs and spread of the work force. This could be addressed by targeted rebalancing interventions that may include additional fellowship spots in ‘underserved’ areas as well as financial and practice incentives. This could be one way of addressing the problem of antimicrobial resistance.