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Meds and you

12 March 2020

Taking more antibiotics may up odds for hospitalisation

Are people who had antibiotic prescriptions for common infections more likely to be hospitalised with other infections?

If your doctors keep giving you prescriptions for antibiotics, you might be at increased risk of hospitalisation for a serious infection, a new report suggests.

For the study, researchers analysed data from two million patients in England and Wales. These patients had received prescriptions for antibiotics between 2000 and 2016 to treat common infections such as upper respiratory tract, urinary tract, ear and chest infections.

Those who had nine or more antibiotic prescriptions for common infections in the previous three years were more than twice as likely to be hospitalised with another infection within three or more months, the findings showed.

The risk was 1.77 times higher among those who had five to eight prescriptions, 1.33 times higher among those who had three to four prescriptions and 1.23 times higher among those who had two prescriptions, the University of Manchester researchers found.

Good bacteria in the gut

Doctors may "prescribe numerous courses of antibiotics over several years, which according to our study increases the risk of a more serious infection. That in turn, we show, is linked to hospital admissions," study author Tjeerd van Staa said in a university news release.

"We don't know why this is, but overuse of antibiotics might kill the good bacteria in the gut (microbiota) and make us more susceptible to infections, for example," he said.

It's clear doctors lack the tools to prescribe antibiotics effectively for common infections, especially when patients already have previously used antibiotics, van Staa said.

"Prescribing antibiotics for a common infection – even though it's not certain whether it's viral, where antibiotics are not indicated, or bacterial, where they are – might be easier when there is little time," he suggested.

Also, in large practices, doctors may be less likely to know their patients and less tuned in to their history and circumstances to make informed decisions, van Staa said.

The study doesn't show a direct cause-and-effect relationship between prescription practices and hospitalisations. And more research is needed to understand the association, the researchers noted.

The study was published online in the journal BMC Medicine.

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