Antibiotics prescribed too often for respiratory tract infections
As many as 11.4 million antibiotic prescriptions written each year for children and teens may be unnecessary, according to a study in the October 2014 issue of Pediatrics.
Antibiotics are frequently prescribed for acute respiratory tract infections even though many are viral infections. In a new study researchers set out to determine bacterial prevalence rates for five common childhood respiratory tract infections; acute otitis media (AOM), sinusitis, bronchitis, upper respiratory tract infection, and pharyngitis and compared the rates to nationally representative antimicrobial prescription rates for these acute respiratory tract infections.
Researchers performed meta-analysis pediatric studies published between 2000 and 2011 to determine acute respiratory tract infections bacterial prevalence rates. In another of children less than 18 years was evaluated in ambulatory clinics sampled by the 2000–2010 National Ambulatory Medical Care Survey (NAMCS) to determine estimated US acute respiratory tract infections antibiotic prescribing.
The researchers estimated that 27.4 percent of US children with acute respiratory tract infections have bacterial illness. This estimate is for infections of the ear, sinus area, throat, or upper respiratory system. However, 57 percent of them were treated with antibiotics. This represents an estimated 11.4 million potentially preventable antimicrobial prescriptions annually.
The researchers write “Currently there are no practical tools for clinicians to use to distinguish viral from bacterial illness, other than the rapid strep test for throat infections. The authors note that such tools are urgently needed and, in the meantime, doctors may add this knowledge of bacterial prevalence as a point in their decision-making and in discussing watch-and-wait strategies or other approaches with families.”
Dr. Matthew Kronman, MD, MSCE, a pediatric infectious disease specialist at Seattle Children’s Hospital, and lead author of study said the results are disheartening, particularly because his team found no appreciable change in prescribing rates over 10 years, as reported by ABC News.
According to Dr. Kronman “Whatever we are doing now, it isn’t working.” “We need to come up with new strategies to understand why this gap exists,” he is referring to the gap between antibiotics needed and those that are prescribed.
Dr. Mark Ebell, MD, Associate Professor of Epidemiology in the University of Georgia College of Public Health commented “For some infections, like acute bronchitis, pharyngitis with a negative strep test, and URI, we know that antibiotics do not help you get better faster and are not needed,” “Even sinusitis and [ear infections] may be caused by viruses and often resolve without antibiotics.”
Learn more about when antibiotics are needed and when they’re not from the Centers of Disease Control and Prevention.
American Academy of Pediatrics News Release
Pediatrics doi: 10.1542/peds.2014-0605)