Antibiotic prescriptions are being written less frequently for patients with respiratory tract infections, which include ear infections, sinus infections and bronchitis, as well as colds and flu.
The finding, published earlier this month, has been received positively by doctors and public health officials who are worried about the increasing problem of "superbugs," disease-causing bacteria that are resistant to antibiotic drugs. "It's a very encouraging finding," says Dr. Stuart Levy, a professor at Tufts University School of Medicine in Boston and and author of a 2001 book on the topic, "The Antibiotic Paradox."
Antibiotics must be used judiciously or they'll start to lose their effectiveness. Bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) and penicillin-resistant Streptococcus pneumoniae are a growing problem as they've become resistant to entire classes of antibiotic drugs. This means many bacterial illnesses are harder to treat. Further, antibiotics that are developed to combat resistant bacteria are generally more expensive and often more toxic.
The most egregious misuse of antibiotics is when they're used to treat a viral illness such as the common cold. Antibiotics are effective against bacteria, not viruses. However, ear infections, sinus infections and bronchitis may be viral, bacterial or both, so sometimes antibiotics are prescribed just in case there's a bacterial component.
A prescription also may be written when a doctor feels pressure from a patient or sleep-deprived parent of a sick child. By acquiescing, the doctor might get better patient-satisfaction scores, says Dr. Carlos Lerner, medical director of the children's health center at Mattel Children's Hospital at UCLA. "Also it's much quicker to write a prescription than to explain to families why an alternative approach is more desirable."
The study, published Aug. 19 in the Journal of the American Medical Assn., examined national survey data from the years 1995-2006. In children younger than 5, rates of antibiotic prescription decreased by 27% overall, and by 36% in patients with respiratory tract infections. In children 5 and older and adults, overall rates of antibiotic prescription didn't change over the study period, but an 18% decrease was found for people with respiratory tract infections.
