For several years, there has been a large effort by the Centers for Disease Control and Prevention and others to reduce inappropriate antibiotic prescribing. Despite that, new research from Brigham and Women’s Hospital (BWH) finds only small improvement in antibiotic dosing for adults with 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,” said Jeffrey A. Linder, MD, MPH, a physician and researcher in the Division of General Medicine and Primary Care at BWH and senior author of the paper. “Our research shows that while only 10% 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%. For acute bronchitis, the right antibiotic prescribing rate should be near zero percent and the national antibiotic prescribing rate was 73%.
The researchers found that while visits for sore throats decreased from 7.5% of primary care visits in 1997 to 4.3% percent of visits in 2010, the overall national antibiotic prescribing rate did not change with physicians prescribing antibiotics at 60% of visits.
The research also found that prescriptions of penicillin, the antibiotic recommended to treat strep throat, remained at 9% while prescribing for azithromycin, a more expensive antibiotic increased from being too infrequent to measure reliably in 1997 -1998 to 15% of visits in 2009 -2010. The researchers also noted an increase in the antibiotic prescribing rate in emergency rooms, from 69% to 73%, during the same 14-year period.
Lead author, Michael L. Barnett, MD, said, “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.” And, he added that most sore throats and cases of acute bronchitis should be treated with rest and fluids and do not require a visit to the doctor……. Science Daily 10/3/13