When antibiotics were first discovered, the way modern medicine would be practiced going forward changed dramatically. Physician had finally found a way to combat so many bacterial infections and diseases. However, as with any medicine, there are side effects if they are used for anything but their intended use. So why is the antibiotic prescription rate for acute bronchitis on a steady incline despite Center for Disease Control And Prevention guidelines?
Michael L. Barnett, M.D. and Jeffrey A. Linder, M.D from Brigham and Women's Hospital in Boston found that despite there being guidelines discouraging their use, antibiotics are still prescribed for acute bronchitis by many physicians. The research was published in JAMA.
“We were hopeful that the CDC [Centers for Disease Control and Prevention] and health plans would discourage people from prescribing antibiotics when it wasn’t necessary,” Dr. Linder tells Medical Daily. “Currently the correct rate of prescribing is zero.”
Acute bronchitis is a respiratory infection, causing inflammation in the bronchial tubes. It causes a person to cough, which brings up mucus, wheezing, chest tightness, and shortness of breath. Since it’s caused by the same virus as a common cold and the flu, acute bronchitis will go away in a few days, but it might leave a lingering cough for a few weeks. Dr. Linder says that this should not be confused with chronic bronchitis which is a persistent lung condition.
The researchers looked at data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, which are surveys that collect information regarding physicians, outpatient practices, and emergency departments as well as patient-level data including demographics, reasons for visits, diagnoses, and medications, according to a news release. Dr. Linder tells Medical Daily that all of the patients were seemingly healthy, did not have chronic bronchitis, and did not have any immune disorders.
The researchers found that between 1996 and 2010 the rate of prescribing antibiotics rose by an astounding 70 percent. Dr. Barnett and Dr. Linder say that this is clear ineffectiveness and with more than 15 years of efforts to educate prescribers, the numbers should be better. However, Dr. Linder does say that a lot of overprescribing has to do with pleasing the patients. “Sometimes a patient will take a half a day off to come into the clinic and it’s unsatisfying to tell someone you have this cough and it’ll go away,” he said.
Despite making efforts to try and please the patients, doctors also worry about resistant strings of bacteria due to the over prescription of antibiotics. “It’s a medicine that’s not going to help and somewhere between five and 25 percent of people will have side effects,” Dr. Linder said.
Dr. Linder recommends fighting this over-prescribing epidemic by being proactive. “Continuing education, giving patients the knowledge, and letting them know there is nothing we can do to help it get better faster.”
Source: Barnett M, Linder J. Antibiotic Prescribing For Adults With Acute Bronchitis in the United States, 1996-2010. JAMA. 2014.