The Scary Truth About Antibiotic Overprescription

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When a patient complains of a sore throat or bronchitis, doctors prescribe antibiotics much more often than is medically necessary. That’s the main takeaway of a new study published in the peer-reviewed journal JAMA Internal Medicine. Findings from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey reveal that doctors prescribed antibiotics to 60 percent of sore throat patients—despite the fact that the drugs are only thought to be necessary in about 10 percent of cases. For acute bronchitis, antibiotics are not recommended at all, yet the researchers—a team from Harvard—found that doctors prescribed antibiotics to an astonishing 73 percent of patients diagnosed with the condition. 

“We use azithromycin for an awful lot of things, and we abuse it terribly,” one doctor told the New York Times.

The number of doctor visits for acute bronchitis tripled between 1996 to 2010, from about 1.1 million visits to 3.4 million visits. The number of sore throat visits actually declined from 7.5 percent of all visits in 1997 to 4.3 percent in 2010—and yet the rate of antibiotic prescription remained consistent.

Another interesting finding: the growing popularity of expensive, broad-spectrum antibiotics such as azithromycin over tried-and-true strep-targeting drugs like penicillin. Last year, the New York Times noted that azithromycin “may increase the likelihood of sudden death” in adults who have or are at risk for heart disease. In that piece, Dr. John G. Bartlett, a professor of medicine at Johns Hopkins University School of Medicine, told the Times that he believed that overprescription of azithromycin could also contribute to antibiotc resistance. “We use azithromycin for an awful lot of things, and we abuse it terribly,” he said. “It’s very convenient. Patients love it. ‘Give me the Z-Pak.’ For most of where we use it, probably the best option is not to give an antibiotic, quite frankly.”

If the looming threat of antibiotic resistance isn’t reason enough for concern about doctors’ free hand with antibiotics, there’s also the considerable cost to our health care system—an estimated $500 million for antibiotics prescribed unnecessarily for sore throat alone between 1997 and 2010. If you include the cost of treating the side effects of unnecessary antibiotics such as diarrhea and yeast infections, the study’s authors estimate that the cost would increase 40-fold.

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