Antibiotics are overprescribed – study

2011-11-08 07:16

Pediatricians in the US write more than 10 million unnecessary antibiotic prescriptions every year for conditions such as the flu and asthma, contributing to potentially dangerous drug resistance, a study said.

Researchers looked at a nationally representative sample of almost 65 000 outpatient visits by children under 18 during 2006 to 2008, with findings reported in the journal Pediatrics.

In total, doctors prescribed an antibiotic at one in every five visits, with most dispensed for children with respiratory ailments such as sinus infections and pneumonia.

Some of those infections were caused by bacteria, warranting antibiotics. But almost one-quarter of all antibiotic prescriptions were given to children with respiratory conditions that probably or definitely do not call for antibiotics, such as bronchitis, the flu, asthma and allergies.

That translates to more than 10 million antibiotic prescriptions each year that likely won’t do any good but might do harm, said study leader Adam Hersh of the University of Utah in Salt Lake City.

“One reason overuse occurs is because the diagnosis is often unclear – this is common with ear infections.

The decision is made to prescribe an antibiotic even though the diagnosis isn’t certain, just to be on the safe side,” he said.

Half of all the antibiotics prescribed were “broad-spectrum” drugs, which act against a wide range of bacteria – killing more of the good bacteria in the bodies as well and perhaps setting the child up for more serious infections with antibiotic-resistant bacteria later on.

“Antibiotics are wonderful. There are times when you really need them. The question is just being judicious about when we use them,” said Betsy Foxman, an epidemiologist at the University of Michigan School of Public Health in Ann Arbor, who was not involved in the research.

In addition, giving antibiotics to children when they aren’t needed raises the risk of antibiotic-resistant infections in both the children themselves and society as a whole, she said.

“We think of antibiotics as being wholly beneficial, but they are not very specific. They hit everything in your body. By making our microbes that are supposed to be with us disappear, we can be causing other health problems we don’t know about.”

And to avoid overprescription? Hersh said that one way might simply be to wait several days and check the child again.

“If the diagnosis is still a little unclear, ask if it would be safe to wait a day or two with close follow-up rather than starting the antibiotic right away,” he added.

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