Study: More than 25% of powerful antibiotic prescriptions are useless

Inappropriate antibiotic use can create drug-resistant bacteria, researchers warn

A majority of U.S. physicians opt for the most powerful drugs when prescribing antibiotics, even though more than a quarter of such prescriptions are ineffective, according to a recent study in the Journal of Antimicrobial Chemotherapy.

For the study, researchers examined data on more than 238,000 ambulatory visits made by U.S. adults between 2007 and 2009.

They found that 61% of antibiotic prescriptions were for broad-spectrum antibiotics, drugs capable of killing multiple types of bacteria, while just 39% of prescriptions were for narrow-spectrum antibiotics. Many of the broad-spectrum prescriptions were for respiratory problems, skin infections, and urinary tract infections.

Of the broad-spectrum antibiotic prescriptions, more than 25% were useless because the infections were caused by viruses.

Based on the sample data, the researchers estimated that antibiotics were prescribed during 101 million physician visits nationwide over the study period, and 62 million of those prescriptions were for broad-spectrum antibiotics.

Researchers warn against inappropriate antibiotic prescriptions

Though the study was based on adult ambulatory antibiotic prescribing, the prescription pattern for children is similar, according to senior study author Adam Hersh, a professor and infectious-disease expert at the University of Utah School of Medicine.

Related: How one hospital eliminated inappropriate antibiotic prescriptions

"Many antibiotics prescribed for children are unnecessary, particularly for conditions caused by viruses, where antibiotics don't help at all," he said in a statement, adding, "Even when an antibiotic is indicated, such as for strep throat or some ear infection, physicians often prescribe an antibiotic such as a Z-Pak, which can be less effective than amoxicillin."

Study coauthor Lauri Hicks cautioned that the overuse of broad-spectrum antibiotics, particularly when the cause of infection is uncertain, contributes to "the development of antibiotic resistance, which is when bacteria survive by outsmarting the antibiotic." As such, "Common infections become difficult to treat, and when you really need an antibiotic, it may not work," she said.

Hersh asked patients to get more involved in their care by questioning whether antibiotics are necessary and are the best choice for their infection (American Medical News, 8/12; Preidt, HealthDay, 8/8).

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