Antibiotics Being Prescribed Less for Respiratory Infections

TUESDAY Aug. 18, 2009 -- Prescribing antibiotics to treat respiratory tract infections has dropped significantly in recent years, a new study has found.

That's mainly the result of fewer young children being seen for ear infections, according to the researchers. But despite a decline overall, prescriptions for broad-spectrum antibiotics, such as azithromycin (Zithromax), and anti-microbial agents known as quinolones have increased, they reported. Such drugs are used to fight more serious infections, such as MRSA and other resistant bacteria.

"There is good news about declining antibiotic use, since inappropriate use of antibiotics can result in bacteria that are resistant to these antibiotics," said Dr. Marie R. Griffin, a professor of preventive medicine at Vanderbilt University Medical Center and a co-author of the study. "However, overuse of powerful antibiotics remains a problem."

"Antibiotics should only be used for bacterial infections, and heavy-duty antibiotics should be saved for serious infections," Griffin said.

Over the last 12 years, she said, use of antibiotics in children has declined 36 percent. "This is mainly due to educational efforts to reduce inappropriate use of antibiotics for viral infections and to a new vaccine -- pneumococcal conjugate vaccine for infants, which has reduced ear infections in children," she said.

For the study, which is published in the Aug. 19 issue of the Journal of the American Medical Association, the researchers looked at the trends in prescriptions for antibiotics from 1995 to 2006, using data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey.

They found that medical visits for ear infections among children younger than 5 declined 17 percent in that time, and antibiotic prescription rates dropped 27 percent.

The study attributed the decrease to a 36 percent reduction in antibiotic prescriptions for respiratory tract infections. Rate of doctor visits for ear infections fell 33 percent over the study period, and rates of antibiotic prescriptions specifically for ear infections fell 36 percent, the researchers found.

Among those 5 and older, doctor visits for respiratory tract infections remained about the same, but antibiotic prescription rates for those infections dropped18 percent. Prescription rates for antibiotics for other conditions for which antibiotics are rarely indicated dropped 24 percent in this age group, the study found.

In the past decade, initiatives in the United States have urged the judicious use of antibiotics, particularly for acute respiratory tract infection, which is a common reason for people to see a doctor and a frequent reason for antibiotic prescriptions, especially for young children, the researchers noted.

The use and misuse of antibiotics can increase the likelihood that bacteria will become resistant to antibiotics. Infections caused by antibiotic-resistant microorganisms have been associated with increased illness, death and substantial costs, the researchers said.

Dr. Stuart B. Levy, president of the Alliance for the Prudent Use of Antibiotics and a professor of medicine, molecular biology and microbiology at Tufts University School of Medicine, said he thinks the trend toward less antibiotic use is encouraging.

"It's a wonderful finding," Levy said. "The message is getting out there. There is a major thrust in the appropriate use of antibiotics -- the realization that if we reduce the use of antibiotics, we will reduce the levels of resistance."

Levy added that it also has become easier for doctors to tell patients they don't need antibiotics.

"Now patients are saying: 'If I don't need the antibiotic, why should I take it?' That is a good sign," he said.

People are getting the message that "antibiotics are not cure-alls, and a consequence of antibiotic usage and misuse is the resistance that emerges," Levy said.

More information

The Alliance for the Prudent Use of Antibiotics has more on antibiotic resistance.

Posted: August 2009


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