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Antibiotic Misuse in the Doctor’s Office

Antibiotic Misuse in the Headlines

By now, most people are aware of the growing problems of antibiotic misuse and antibiotic-resistant bacteria.  But many of us have trouble understanding just how big this problem is.

We covered a recent study that took a closer look at how prominent this issue is within industrial agriculture – and that’s a big part of the problem.  But there is a whole other side to this antibiotic-resistance problem… and the other side is much closer to home.

Read more: Antibiotic Resistance on the Move

Antibiotic Misuse in Healthcare

Doctors prescribe antibiotics regularly and casually, telling us that the antibiotics are the best course of action.  Because we trust our doctors, we default to their guidance – and often their guidance is to take prescription antibiotics – for a huge spectrum of different illnesses.

We want to make the best choice for our health, or the health of our loved ones.  So if you’re someone who is concerned about the misuse of antibiotics, it can be very difficult to know when they are truly necessary.

If you don’t have a medical education and you haven’t kept up to date with the vast body of research on the topic – you’re stuck in a guessing game with some very high stakes.

Get caught up: Antimicrobial Resistance in the News

Judicious Use or Misuse?

Back in March of 2015, the White House issued their National Action Plan for Combating Antibiotic-Resistant Bacteria.  Part of the plan they proposed is to curtail the dependence of healthcare providers on antibiotics, by defining a set of standard practices for how antibiotics are used – when, what dosage, duration of treatment, etc.

The plan vaguely calls for “judicious use” of antibiotics. In order to start spelling out exactly what “judicious use” means, the medical community needed to first take a look at how antibiotics are used, or misused, today.  And that’s where this new study comes in.

One Third of Antibiotic Prescriptions are Unnecessary

Earlier this month, the Journal of the American Medical Association released a study called, “Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011.”  The study was carried out by doctors from the CDC, with help from hospitals around the country – and was partially funded by the Pew Charitable Trust.

The study’s authors looked at a sample set of 184,032 office visits, and found that a prescription for antibiotics was written as a result of about 13% of those visits.  Many of these prescriptions were found to be unnecessary, and many were issued for viral conditions that do not respond to antibiotics at all.

The bottom line is that in America in 2010-2011, about one third of the outpatient antibiotic prescriptions written were inappropriate (according to CDC standards).  That means at least 1 out of every 3 antibiotic prescriptions should not have been written.  When you do the math, that adds up to about 47 million antibiotic prescriptions per year that should not be issued.

Infographic: Is Your Lunch Full of Antibiotics? A Fast Food Report Card

Antibiotic Misuse for Respiratory Diseases

Almost half (44%) of the antibiotic prescriptions in the sample were written for acute respiratory conditions. Of those, a full 33% were written for viral conditions like flu and bronchitis that don’t respond to antibiotics at all.

The numbers in this study are a little hard to believe.  How could our doctors be misusing antibiotics to this extent?  But the JAMA issued an editorial piece along with the study, explaining that the actual situation is probably much worse.  The study didn’t take into account prescriptions written by dentists, physician’s assistants, or nurses; or those issued as a result of phone calls, visits to urgent care clinics, or retail pharmacies.

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Sources:
Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011. http://jama.jamanetwork.com/article.aspx?articleid=2518263

Addressing the Appropriateness of Outpatient Antibiotic Prescribing in the United States.  http://jama.jamanetwork.com/article.aspx?articleid=2518237

1 in 3 antibiotics prescribed in U.S. are unnecessary, major study finds.  https://www.washingtonpost.com/news/to-your-health/wp/2016/05/03/1-in-3-antibiotics-prescribed-in-u-s-are-unnecessary-major-study-finds/

National Action Plan for Combating Antibiotic-Resistant Bacteria. https://www.whitehouse.gov/sites/default/files/docs/national_action_plan_for_combating_antibotic-resistant_bacteria.pdf

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COMMENTS(8)

  • Not only are antibiotics not useful for a huge number of illnesses, they contribute to the suppression of the immune system, something that is vital to our long term good health. Good homeopathic treatment is not only highly effective, it promotes a strong and vibrant immune system and is very economical. You can even learn how to use some of the common remedies for acute conditions at home – and in the garden. You can deter insects from eating your food crops and save trees from destructive insects. When you are conversant in its use. it’s hard to imagine life without it.

  • The flagrant use of antibiotics is quite distressing. I have treated my family and myself with herbs, supplements, and vitamins for nearly twenty years and have only resorted to antibiotics a few times during those years.

    Another component to building one’s health is building the gut flora. A healthy gut is the root of a healthy person.

  • Jen says:

    I’m actually very happy to hear that antibiotics are only being prescribed at about 13% of doctors visits. That is huge progress from decades past. When the majority of visits resulted in antibiotic prescriptions. My understanding of antibiotic resistance is that it has a lot more to do with exposing bacterial infections to antibiotics, but not fully treating them. In other words, people not finishing the antibiotics. Also our constant exposure to them in our environment, like or food. Don’t get me wrong, there should be a lot more throat cultures and other tests for bacteria; we have the technology and it’s not used nearly often enough. It’s not that difficult to tell if bronchitis is bacterial or viral, but I adamantly disagree with your assertion that it’s always viral, it can be bacterial. Bronchitis is, by definition, inflammation of the bronchi in the lungs. Just as tonsillitis is inflammation of the tonsils. Symptoms are not cause. Pneumonia always starts with inflammation which is bronchitis. Pneumonia is often bacterial and very life threatening, so your statement doesn’t hold true. The “studies” this article refers to sound much more like data mining, which is extremely unreliable. No one can know for certain which antibiotic prescriptions were unnecessary without tests. Either the antibiotic worked on the bacteria or the virus passed. The result is the same regardless. Speculation using data without true participation, like running tests for bacteria, is just data mining.

  • Sheryl Gambardella says:

    I am a nurse practitioner and can say I m pressured daily to prescribe antibiotics. Patients frequently say” I don’t normally use them but I have to….(fill in any thing you can think of that is more important to them than their long term health)” Parents worried about children are understandably worried. We need to re-educate the public yes, but we also need to give people an alternative BEFORE they get sick to keep them healthy. Unfortunately until ill it’s not usually a priority. I routinely give people the measures to avoid whatever illness they present with for the future. It is a long term and slow going teaching plan.

  • Denise says:

    And yet are doctors swear to “do no harm” that’s a crock of manure.

  • Lori Dorchak says:

    I was very angry when my dermatologist prescribed antibiotics for a ,mild case of acne! ?

  • ellie says:

    I provide home daycare for a 1 year old. He’s already been on 3 doses of antibiotics! How do you educate parents that are completely oblivious? I did get his mom to stop bringing a popular brand ‘organic’ flavored yogurt for me to feed him. I asked her if she knew the cute little single serving had 1-1/2 teaspoons of sugar in it? She had no idea. I told her I make my own and will feed him some of it.

    1. Marilee says:

      Wow, your post makes mine look felebe. More power to you!

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