Of the 154 million prescriptions for antibiotics written in 2010 and 2011, more than 46 million were inappropriate, according to the Centers for Disease Control and Prevention (CDC).

The research, published in the Journal of the American Medical Association, examined 182,032 patient visits in 2010 and 2011 from two studies funded by the CDC. By establishing a rate of inappropriate antibiotic prescription, the study authors hope to support efforts boosting antibiotic stewardship.

The research concludes a “substantial amount” of overuse can be attributed to overdiagnosis of conditions that are commonly treated with antibiotics, such as sinusitis. A 15 percent reduction in overall antibiotic use would need to occur to meet federal goals of reducing inappropriate use by 50 percent by 2020.

A follow-up editorial in JAMA recommended further research to help improve the understanding of overprescribing antibiotics.

“Now that baseline estimates about outpatient antibiotic prescribing have been determined, future work needs to focus on interventions targeting both clinicians and patients to help reach the national goal,” wrote Pranita Tamma, MD, MHS, and Sara Cosgrove, MD, MS. “It will be critical to continue to evaluate progress in improving antibiotic use in conjunction with widespread adoption of antibiotic stewardship activities in the outpatient setting.”