Navigation Links
When prescribing antibiotics, doctors most often choose strongest types of drugs
Date:8/1/2013

(SALT LAKE CITY)When U.S. physicians prescribe antibiotics, more than 60 percent of the time they choose some of the strongest types of antibiotics, referred to as "broad spectrum," which are capable of killing multiple kinds of bacteria, University of Utah researchers show in a new study.

Unfortunately, in more than 25 percent of such prescriptions are useless because the infection stems from a virus, which cannot be treated with antibiotics. This overuse of antibiotics has a number of downsides, including that these types of drugs kill more of the "good" bacteria found in our bodies which may lead to more side effects and also contribute to the growth of antibiotic-resistant bacteria, according to Adam L. Hersh, M.D., Ph.D., an infectious disease expert, assistant professor of pediatrics at the University of Utah School of Medicine and senior author on a study published July 29, 2013, in the Journal of Antimicrobial Chemotherapy.

Discerning whether an infection is viral or bacterial can be tricky, according to Hersh, which probably accounts for much of the overuse of antibiotics. "It seems that the natural bias, when there is uncertainty about an infection's cause, is to err on the side of prescribing antibiotics," he says. "Our study found that the majority of prescriptions are for antibiotics that kill a wider range of bacteria, and that they are most likely to be given when they're not needed, such as in cases of viral infections."

The types of illnesses where doctors seem to choose stronger antibiotics include respiratory problems, skin infections and urinary tract infections, which in many cases would be better treated by other antibiotics that are less likely to cause resistance.

Hersh, Andrew T. Pavia, M.D., also an infectious disease expert and professor of pediatrics at the University of Utah, Lauri A. Hicks, D.O., a medical epidemiologist at the U.S. Centers for Disease Control and Prevention, and University of California, San Francisco, medical student Daniel J. Shapiro, conducted the study using a public database with information on ambulatory care visits at physician offices and hospital-based outpatient and emergency departments nationwide. Studying data from between 2007-2009, they identified a sample of 238,624 visits by patients 18 and older at those medical facilities and found that 61 percent of antibiotic prescriptions were for broad-spectrum drugs, such as Levaquin. Narrow-spectrum antibiotics, such as amoxicillin and doxycycline, comprised the remaining 39 percent of antibiotic prescriptions.

Based on the sample of 238,000-plus visits, the researchers estimate there was an average of 985 million annual ambulatory care visits for the 2007-2009 period, with antibiotics being prescribed in an estimated 101 million of those visits each year 62 million in which broad-spectrum antibiotics were prescribed and 39 million that resulted in narrow-spectrum antibiotics prescriptions.

While this study looked only at adult ambulatory care visits, the prescription pattern for children is similar, according to Hersh. "Many antibiotics prescribed for children are unnecessary, particularly for conditions caused by viruses, where antibiotics don't help at all," he says. "Even when an antibiotic is indicated, such as for strep throat or some ear infection, physicians often prescribe and antibiotic such as a Z-Pak, which can be less effective than amoxicillin."

Hicks emphasizes that antibiotic overuse among children and adults is a serious problem and a threat to everyone's health. "The biggest problem with using antibiotics when they're not needed is the development of antibiotic resistance, which is when bacteria survive by outsmarting the antibiotic," she says. "Common infections become difficult to treat, and when you really need an antibiotic, it may not work."

Uncertainty about the cause of an infection is one factor in the overuse of broad-spectrum antibiotics, but there are other influences too, according to Hersh. This includes a misperception by physicians that their patients expect an antibiotic if they take the time to see the doctor. But Hersh believes this second factor is changing, due in part to major efforts to educate people about the problems associated with overuse of antibiotics, such as CDC's "Get Smart: Know When Antibiotics Work" program.

"The public is increasingly aware of the downside and side effects of antibiotics," Hersh says. "Actually, when they see their doctor, most patients just want an explanation as to what's wrong and are open to considering why an antibiotic wouldn't be helpful."

He urges patients to play a larger role by asking their doctor two questions: Do I really need this antibiotic? And, is this antibiotic the best choice for my infection?

"Both doctors and patients have a role in ensuring the effectiveness of antibiotics is preserved by using them only when needed," Pavia says.


'/>"/>

Contact: Phil Sahm
phil.sahm@hsc.utah.edu
801-581-2517
University of Utah Health Sciences
Source:Eurekalert

Related medicine news :

1. Variations in antibiotic prescribing of acute rhinosinusitis in united states ambulatory settings
2. Rottenstein Law Group Notes Medical Journal Article Advising Doctors To Use Caution When Prescribing Zithromax and Other Antibiotics
3. Antibiotic Prescribing Rates Vary by Region: Report
4. SiliconMesa Partners with DrFirst to Add E-prescribing and Medication Adherence Functionality to SiliconMesa EHR
5. BU School of Medicine launches safe opioid prescribing education program for health care providers
6. Dr Jonathan Zaidan Opens State-of-the-Art Specialty Center, Women’s Excellence in Endometriosis, Featuring Electronic Medical Records and E-prescribing, near Pontiac, MI
7. Study: Electronic Prescribing Cuts Medication Errors
8. E-Prescribing Market is Growing at a CAGR of 26% & to Reach Worth $794 Million by 2017 - New Report by MarketsandMarkets
9. Overprescribing of opioids impacts patient safety and public health
10. PracticeFusion, DrFirst and Emdeon ranked as Top Electronic Prescribing Vendors Among Satisfied Clients, Black Book 2013 Survey
11. Electronic visits offer accurate diagnoses, may lead to overprescribing of antibiotics
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... ... June 25, 2016 , ... First Choice Emergency Room , the ... Ogunleye, as the Medical Director of its new Mesquite-Samuell Farm facility. , “We ... new Mesquite location,” said Dr. James M. Muzzarelli, Executive Medical Director of First Choice ...
(Date:6/25/2016)... ... ... Friday, June 10, Van Mitchell, Secretary of the Maryland Department of Health and Mental ... exemplary accomplishments in worksite health promotion. , The Wellness at Work Awards took place ... BWI Marriott in Linthicum Heights. iHire was one of 42 businesses to receive an ...
(Date:6/24/2016)... ... ... Those who have experienced traumatic events may suffer from a complex set ... drug or alcohol abuse, as a coping mechanism. To avoid this pain and suffering, ... traumatic event. , Trauma sufferers tend to feel a range of emotions, from depression, ...
(Date:6/24/2016)... , ... June 24, 2016 , ... ... and Scientific Sessions in Dallas that it will receive two significant new grants ... grants came as PHA marked its 25th anniversary by recognizing patients, medical professionals ...
(Date:6/24/2016)... ... June 24, 2016 , ... Comfort Keepers® of San Diego, CA is ... Road To Recovery® program to drive cancer patients to and from their cancer treatments. ... the highest quality of life and ongoing independence. Getting to and from medical ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... -- Dublin ... the " Global Markets for Spectroscopy Equipment" ... This report focuses on the global market ... its applications in various applications. The report deals with ... main industries: pharmaceutical and biotechnology, food and beverage, and ...
(Date:6/24/2016)... SAN CLEMENTE, Calif. , June 24, 2016  American ... function testing company, is now able to perform sophisticated lung assessments ... ndd Medical Technologies , Inc. Patients are no ...  Thanks to ndd,s EasyOne PRO ® , ARL patients like Jeanne ... needed testing done in the comfort of her own home. ...
(Date:6/24/2016)... NAMUR , Belgium , ...  (NYSE MKT: VNRX), today announced the appointment of ... Board of Directors as a Non-Executive Director, effective ... the Company,s Audit, Compensation and Nominations and Governance ... Board, Dr. Futcher will provide independent expertise and ...
Breaking Medicine Technology: