6
&
February 2014
Too Many
Antibiotics?
By Fiona Young-Brown
If it seems as if everywhere you
turn there are infants with ear infections or other ailments that call for
yet another antibiotic prescription,
you’re not alone. And it’s not just
children that are taking too many
antibiotics; last year it was found that
although only 10 percent of adults
with sore throats have strep — an
infection requiring antibiotics —
some 60 percent of the cases would
receive a prescribed antibiotic.
Antibiotics are used to treat bacterial infections but they are not without their downsides; stomach upsets,
diarrhea, hives, and vaginitis are just
some of the possible side effects.
Furthermore, the more frequently
you take antibiotics, the greater the
likelihood that the bacteria within
your body will develop a resistance,
making them less effective when you
truly do need them.
Unfortunately, for all the evidence
that doctors may be over-prescribing
them, there is equal evidence that
patients may be demanding them
when they are not appropriate, believing them to be a cure-all. The strep
findings mentioned above are just
one suggestion that antibiotics are
overused; another study, presented
at IDWeek 2013, an annual meeting
of health professionals found that
the prescribing rate of antibiotics for
bronchitis was roughly 73 percent.
This is despite the fact that acute
bronchitis is usually viral, and therefore unable to be treated by antibiotics.
The problem of over-prescription
is equally, or perhaps more problematic in children since repeated doses
during infancy means that resistance
will develop at an even younger age.
In November, 2013, the American
Academy of Pediatrics issued a report
aimed at reducing unnecessary antibiotic prescriptions. The report found
that more than one in five pediatrician visits resulted in a prescription
for antibiotics. That translates to
approximately 10 million unnecessary
prescriptions each year. It should be
noted that the report looked at upper
respiratory infection cases, which
includes ear infections, sinus infections and strep throat. Adding to the
problem — the prescriptions tend
to be for broad spectrum as opposed
to narrow spectrum antibiotics. It is
these broad spectrum drugs that are
most likely to develop future drug
resistance. And those ear infections?
It turns out that fluid in the ears is
relatively common, but antibiotics are
only needed if pain is severe or the
eardrum is bulging. Likewise, many
children prescribed antibiotic treatment for suspected strep are simply
carriers, rather than actually having
the condition.
When feeling ill or dealing with a
sick child, the desire to find a quick
solution is understandable, and so is
the desire for a prescription. But it
is essential to realize that a course of
antibiotics may be doing more harm
than good, and not even treating
the original problem. The American
Academy of Pediatrics suggests parents consult with their doctor and
have an honest discussion as to what
treatments are most appropriate,
remaining aware that antibiotics may
not be the best option. One source,
helpful for both children and adults,
is available through the Centers for
Disease Control at
http://www.cdc.
gov/getsmart/
antibiotic-use/URI/
index.html. Here is a
quick summary:
• Sinus infections – rarely
caused by bacteria. More likely to
be viral and therefore unresponsive to antibiotics.
• Sore throat – usually gets better
on its own. Only use antibiotics if
strep throat is confirmed by test.
• Ear infections – may or may
not need antibiotics. Discuss the
best course of treatment with
your physician.
• Common cold – typically viral.
Antibiotics are unlikely to help.
• Bronchitis – usually viral. In rare
occasions, bronchitis may be bacterial, but antibiotics will usually
be ineffective.
For more information about appropriate antibiotic use, visit http://
www.healthychildren.org/English/
news/Pages/Get-Smart-AboutAntibiotics.aspx