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A new study reveals that almost 25% of antibiotics prescribed in the United States are given for conditions they are not supposed to treat.
Antibiotics are miracle drugs that can heal life-threatening bacterial infections. But all too often, they are prescribed to treat viral infections, such as colds and flu, for which they are ineffective.
And the overuse of antibiotics carries risks to public health, experts warned.
"The prescription of antibiotics is one of the major drivers of the development of antibiotic-resistant bacteria," said Dr. Kao-Ping Chua, Senior Researcher, Assistant Professor of Pediatrics at the University of Michigan in Ann Arbor.
Antibiotic-resistant bacteria are one of the biggest health threats in the world, he said.
Each year, two million Americans develop antibiotic-resistant infections and 23,000 die, according to US Centers for Disease Control and Prevention.
"Given this, it is urgent that providers eliminate the inappropriate prescription of antibiotics, both for the sake of their own patients and for society in general," Chua said.
For the study, Chua and his colleagues have studied the insurance registers of more than 19 million children and adults under 65 years old. All patients were privately insured.
Inappropriate prescription remains widespread
Researchers said more than 23% of prescriptions were medically inappropriate or unjustified. Inappropriate prescriptions mainly concerned colds, chest infections and coughs.
Approximately 36% of prescriptions could have been appropriate, but unnecessary, as they involved conditions such as sinusitis and sore throats, which can be viral.
Most of the inappropriate prescriptions came from doctors' offices, emergency care centers and emergency rooms. The study found that nearly 29% of prescriptions did not have a diagnosis code and could be inappropriate because some were given on the basis of telephone or online consultations.
The researchers found that in 2016, one in seven patients had administered at least one unnecessary antibiotic prescription. This translates into one in ten children and about one in six adults.
"The most recent national studies on excessive consumption of antibiotics in the United States have used older data from the first half of this decade," said Chua. "Our study shows that despite widespread efforts to improve quality, inappropriate prescription of antibiotics was still prevalent in 2016."
Dr. Marc Siegel, professor of medicine at NYU Langone Medical Center in New York City, is convinced that inappropriate antibiotic prescriptions are more prevalent than what this study has revealed.
"Surely we over-prescribe a lot of antibiotics," he said.
Allergy risk
The reasons are many and varied. According to Siegel, for example, almost all upper respiratory tract infections are of viral origin, but many doctors fear not having the rare bacterial infection and prescribe an antibiotic just in case. And patients often ask for it.
Doctors must ask more questions about the patient's condition before writing a prescription, he said.
"It's a clinical decision to decide to prescribe antibiotics," Siegel said. "We tend to want the patient to feel better."
Although doctors often think that there is no harm in giving a packet of antibiotics, this can cause problems for some patients.
For example, some patients with heart problems may develop an irregular heartbeat, Siegel explained. Antibiotics can also kill children's intestinal bacteria and put them at risk for allergy, he added.
"Patients should not push their doctors for antibiotics," Siegel said. "Doctors, do not feel obligated to give a pill that might not be necessary."
The report was published online in a peer-reviewed medical journal. The bmj.
Image credit: iStock
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