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A Bitter Pill: Fighting Antibiotic Overuse


Millions of prescriptions are written for antibiotics each year and a new study from the Centers for Disease Control and Prevention shows nearly a third of them are unwarranted. This has the CDC, along with the Pew Charitable Trusts, calling for medical providers to take action to reduce the number of antibiotics they prescribe.

"For a long time, many physicians believed that erring on the safe side for our patients was to prescribe an antibiotic just in case, even if the diagnosis of a bacterial infection was not certain," says Adam Hersh, MD, a pediatric infectious disease specialist with University of Utah Health. "Increasingly, we are realizing that being on the safe side often means not prescribing an antibiotic."

In cases where an unnecessary antibiotic is given, a patient could be put at risk for developing bacteria that are resistant to the drugs. That means the antibiotics may not work at a later time when they are truly needed. In addition, antibiotics wipe out the "good" bacteria living in the body, leaving patients without natural defenses for a period of time. "Physicians and patients alike do not fully appreciate the fact that antibiotics are like friendly fire - they unintentionally kill many of the good bacteria in our bodies. This seems to be linked to longer-term health problems," says Hersh.

Pediatrics is a main focus when it comes to reducing the number of antibiotics prescribed each year. Currently, young children have the highest rate of antibiotic prescription in the United States each year. "Many young children receive one or more antibiotic prescriptions each year," says Hersh.

The majority of antibiotic prescriptions for children are written for ear infections. In many cases, an infection may be viral in nature, meaning an antibiotic will not help with its treatment. In other cases, it may not be an ear infection at all. "Diagnosing an ear infection is sometimes not so clear cut," says Hersh. "Being certain about the diagnosis before prescribing the antibiotic is a critical part of this fight against antibiotic overuse."

The goal right now is to reduce the number of antibiotic prescriptions for ear infections by at least 10 percent in patients under the age of 19.

Changing patient expectations is another key to reducing antibiotic overuse. In adults, the most unneeded antibiotic prescriptions are written for acute respiratory conditions like sinusitis - which will resolve on its own in the majority of cases.

"Physicians sometimes perceive, often incorrectly, that patients expect an antibiotic prescription, even when it's not the right treatment," says Hersh. Instead of writing a prescription, medical providers should encourage patients who don't necessarily need antibiotics to treat their symptoms with over-the-counter medications.

"Antibiotic overuse and the consequences of antibiotic resistance are among the most important health threats we face," says Hersh.