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Children overprescribed antibiotics for sore throat

sore throat and nonrecommended antibiotics to 27 percent of children who received an antibiotic. Antibiotic prescribing decreased from 66 percent of visits in 1995 to 54 percent of visits in 2003. This decrease was attributable to a decrease in the prescribing of recommended antibiotics (49 percent to 38 percent). Physicians performed a GABHS test in 53 percent of visits and in 51 percent of visits at which an antibiotic was prescribed. GABHS testing was not associated with a lower antibiotic prescribing rate overall (48 percent tested vs. 51 percent not tested), but testing was associated with a lower antibiotic prescribing rate for children with diagnosis codes for pharyngitis, tonsillitis, and streptococcal sore throat (57 percent tested vs. 73 percent not tested).

"In conclusion, we found that physicians prescribed antibiotics less frequently over time to children with sore throat. However, the overall antibiotic prescribing rate continues to exceed the expected prevalence of GABHS, and physicians continue to select unnecessarily broad-spectrum antibiotics. Unnecessary antibiotic prescriptions are not benign: they increase the prevalence of antibiotic-resistant bacteria, expose patients to adverse drug events, and increase costs. Perhaps unique among upper respiratory tract infections, clinicians have good, objective criteria in the form of GABHS testing to guide the antibiotic treatment of children with sore throat. Limiting antibiotic prescribing to children with a positive GABHS test result is a feasible goal for primary care physicians and an important step toward judicious use of antibiotics overall," the authors write.


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Source:JAMA and Archives Journals


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