Antibiotic Prescriptions Too Common

A new report finds that doctors in the United States often prescribe antibiotics for virus-caused common respiratory that do not respond to antibiotic treatment. Antibiotics, when used too frequently, can cause bacteria to become resistant to them, thereby rendering the drugs useless against future infections with these bacteria.

Survey results for 1992 showed that 51% of their patients diagnosed with colds, 52% of those with upper respiratory tract infections (URIs), and 66% of patients diagnosed with bronchitis received antibiotic prescriptions. The conditions of colds, URIs, and bronchitis account for more than 12 million or 21% of all ambulatory antibiotic prescriptions to adults.

Experts at the U.S. Centers for Disease Control (CDC) blame physicians for the major reason for these unnecessary antibiotic prescriptions " unrealistic patient expectations, coupled with insufficient time to discuss with patients why an antibiotic is not needed. Some of the responsbility is with physician ignorance. They continue, "Although less readily admitted, physicians' inadequate knowledge of the spectrum of symptoms and signs and the natural history of respiratory illnesses also contributes to antibiotic overuse." They note, for example, that doctors may prescribe antibiotics for a persistent cough, despite the fact that about 30% of coughs in common colds often persist for 10 days.

The CDC ended by saying: "We encourage all physicians to examine their own practices and identify where they can decrease unnecessary antimicrobial use by improving diagnostic methods or communicating with patients concerning the lack of benefit, potential adverse effects, and development of resistance associated with such therapy."

The Journal of the American Medical Association September 17, 1997;278:901-904;944-945

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