Most Americans with a sore throat are prescribed antibiotics
even though just a fraction stand to benefit from them, a new study shows.
Researchers said only about 10% of adults with sore throats
have strep throat, which is caused by bacteria that could be killed by antibiotics.
Almost all other sore throats are caused by viruses. In those cases, "an
antibiotic is not going to help you and it has a very real chance of hurting
you," Dr Jeffrey Linder, who worked on the study at Brigham and Women's
Hospital in Boston, said.
Although serious side effects are rare, he said antibiotics
can cause diarrhoea or yeast infections and interact with other medicines.
Overuse of the drugs also makes bacteria resistant which mean future
infections could be harder to treat.
For their study, Linder and his colleague Dr Michael Barnett
analysed data on 8 200 US primary care and emergency room visits for sore
throats between 1997 and 2010. They found doctors prescribed an antibiotic at
60% of those visits, with no change in that rate during the study period,
according to findings published in JAMA Internal Medicine.
What did change is that a greater proportion of
prescriptions were for new, expensive antibiotics in recent years even though
penicillin works just fine against strep throat, Linder told Reuters Health.
His team's findings were presented at IDWeek 2013 in San Francisco.
The researchers noted that they didn't have data on each
patient's diagnosis, so they couldn't know exactly when antibiotics were appropriate.
Linder said ideally, doctors should use a few key symptoms to figure out which
patients should be tested for strep throat.
Patients are more
likely to have strep if they have a fever, swollen lymph nodes, white spots on
the tonsils or swollen tonsils and no cough. But the test is often used
"pretty indiscriminately", or people are given antibiotics without
even being tested for strep, Linder said. Dr Ralph Gonzales, who has studied
antibiotic prescribing at the University of California, San Francisco, said the
results weren't all bad news, necessarily.
The proportion of people visiting their primary care doctor
for a sore throat rather than any other complaint dropped from almost 8% to
about 4% during the study period, he noted. He said fewer total visits for sore
throats means fewer antibiotics are being prescribed, even if most people with
achy throats still get the drugs. "At least from a public health
perspective, we're having a lower impact on resistance," Gonzales, who
wasn't involved in the new research, told Reuters Health.
Dr Paul Little, a professor of primary care research at the
University of Southampton in the UK, said people can avoid getting unneeded
antibiotics by not going to the doctor for a run-of-the-mill sore
throat. "The truth is, nasty things are really pretty uncommon,"
Little, who also didn't participate in the study, told Reuters Health.
"What you need
to do is manage your symptoms," he said, such as with over-the-counter
pain relievers and plenty of fluids. "The vast, vast majority of these are
going to get better on their own," Linder agreed. Still, Little said,
"If you're worried about it and you're very unwell... then I think it is
worth it to see a doctor and have a (strep) test."