The health care community has been at odds with excessive antibiotic prescriptions for mild cases of respiratory infection for some time now. Researchers of a study from Brigham and Women’s Hospital (BWH) are calling for further intervention to stop the unnecessary use of antibiotics for conditions such as acute bronchitis and sore throat.
"We know that antibiotic prescribing, particularly to patients who are not likely to benefit from it, increases the prevalence of antibiotic-resistant bacteria, a growing concern both here in the United States and around the world," explained the study’s lead author, Jeffrey A. Linder, M.D., MPH, of the Division of General Medicine and Primary Care at BWH.
According to the Centers for Disease Control and Prevention, antibiotic resistance is the one of the world’s most pressing public health concerns. Antibiotic-resistant bacteria are on the rise as more bacterial infections become immune to the most commonly prescribed antibiotic treatments.
Dr. Linder, along with his colleague Michael L. Barnett, M.D., gathered data from around 39 million acute bronchitis- and 92 million sore throat-related visits to the emergency room or a primary care physician. Between 1997 and 2010, the number of doctors prescribing antibiotics upon hospital visit stayed at 60 percent even though the number of sore throat-related visits dropped by 7.5 percent.
“Our research shows that while only 10 percent of adults with sore throat have strep, the only common cause of sore throat requiring antibiotics, the national antibiotic prescribing rate for adults with sore throat has remained at 60 percent. For acute bronchitis, the right antibiotic prescribing rate should be near zero percent and the national antibiotic prescribing rate was 73 percent," said Linder.
The prescription rate for azithromycin, one of the more expensive antibiotics, was found to be 15 percent in 2009-2010 compared to 1997-1998 when it was too low to be calculated. Penicillin, the most commonly prescribed medication for a sore throat, stayed at nine percent.
"In addition to contributing to the prevalence of antibiotic resistant bacteria, unnecessary use of antibiotics also adds financial cost to the health care system and causes adverse effects for those taking the medication," Barnett said. “Most sore throats and cases of acute bronchitis should be treated with rest and fluids and do not require a visit to the doctor."
Source: Barnett M, Linder J. Antibiotic Prescribing to Adults With Sore Throat in the United States, 1997-2010. JAMA Internal Medicine. 2013.