Repeated warnings that
antibiotics don't work for most sore throats and bronchitis have failed to stop
overuse: US doctors prescribed these drugs for most adults seeking treatment at
a rate that remained high over more than a decade, researchers found.
The results are in two
analyses of US health surveys from the late 1990s to 2010, representing more
than 2 million annual visits to doctors' offices or emergency rooms.
Antibiotics can have bad
side effects, including stomach pain and severe diarrhoea, and inappropriate
prescriptions put patients at needless risk. The practice also can cause
The findings show reducing
inappropriate prescribing "is frustratingly, disappointingly slow,"
said Dr Jeffrey Linder, a physician-researcher at Harvard Medical School and
Brigham and Women's Hospital. He did the research with Brigham colleague Dr
Dr Reid Blackwelder,
president of the American Academy of Family Physicians, said part of the
problem is old prescribing habits that didn't change when evidence emerged
showing most sore throats and bronchitis are caused by viruses; antibiotics
only treat infections caused by bacteria, not colds, flu and other illness from
viruses. Antibiotics can treat include bacterial pneumonia, most
urinary infections, some types of eye and ear infections, and some types of
Patients' demands and
doctors' time pressures also play a role: It's often easier to prescribe an
antibiotic than to take time to explain why they don't work for some illnesses,
Dr Ed Septimus, a professor
at Texas A&M Health Science Centre in Houston, said development of more
rapid testing to identify germs that cause sore throats or bronchitis could
help curb the practice.
The research was presented at an infectious diseases meeting in San Francisco.
One analysis found that
antibiotics were prescribed at 60% of primary-care and emergency room visits
for sore throats in 2010, a rate that didn't budge over 10 years but was down
from about 70% in the 1990s. That study was also published online in
JAMA Internal Medicine.
In an editorial, Dr Rita
Redberg, the journal's editor, noted that only about 10% of sore throats are
caused by strep bacteria – which antibiotics can treat.
The second analysis found
antibiotics were prescribed at 73% of all visits for bronchitis in 2010, a rate
that didn't change from 1996. Only rare cases of bronchitis are caused by
Bronchitis "just needs
to take its time to run its course, which can be frustratingly long,"
sometimes three weeks or more, Linder said.
Some over-the-counter cough
medicines can help bronchitis; gargling with salt water can help sore throats,
and rest and fluids can help both, he said.