Antibiotics overprescribed for sore throats, bronchitis

Vast majorities of people who see physicians for sore throats or acute bronchitis receive antibiotics, yet only a small percentage should, according to analyses of two major national surveys presented recently at the IDWeek meeting in San Francisco

The analysis has been published as a research letter in  the October 3, 2013 issue of JAMA Internal Medicine.

A cross analyses of two major national surveys-the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey-by Harvard University researchers found that antibiotics continue to be significantly overprescribed in the United States.

Senior study author Jeffrey A. Linder, MD, MPH, associate professor of medicine at Harvard Medical School, and colleagues looked at visits by adults to primary care physicians and emergency departments, including a sample of 8,191 visits for sore throats between 1997 and 2010; and a sample of 3,667 visits for acute bronchitis between 1996 and 2010.

Only about 10% of sore throats are caused by streptococcus bacteria and should be treated with antibiotics, according to the researchers. “Yet patients seeing the doctor for a sore throat are given antibiotics 60% of the time,” Linder, associate physician at Brigham & Women’s Hospital, Boston, said. “And while the prescribing rate for acute bronchitis-also viral-is about 73%, it should be near zero.”

These studies are part of a continual effort to assess the status of antibiotic prescribing in the United States. The sore throat study, for example, was a follow-up to a previous cross analyses the researchers conducted based on data from 1989 to 1999.

“The studies provide an update of previous studies using the same national surveys and show that progress in reducing inappropriate prescribing of antibiotics has been slow,” according to Linder.

“Some progress has been made in 10 years-the last analysis showed 70% of patients [that] sought treatment for a sore throat were given antibiotics. But overall, despite attempts to spread the word about the risks of inappropriate use of antibiotics, patients and doctors just aren’t getting it,” he adds .

The overprescription of antibiotics remains a significant problem in the United States, according to Linder. “Little progress has been made in reducing the inappropriate prescribing of antibiotics, leading to the creation of antibiotic-resistant superbugs, which are difficult to treat and a public health threat,” he says. “Additionally, people need to understand that antibiotics are not helpful for treating viral infections, and that, by taking antibiotics inappropriately, they are putting something in their bodies they don’t need and that exposes them to adverse drug reactions, allergies, yeast infections, and nausea. Doctors and patients need to work together to reduce the overprescription of antibiotics.”