A vast majority of people who see their doctors for sore throats or acute bronchitis receive antibiotics, yet only a small percentage should, according to analyses of two major national surveys being presented at IDWeek 2013-. Those illnesses usually are caused by viruses, and antibiotics - which only treat bacterial infections - do not help.
Harvard University researchers analyzed the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey and determined that doctors prescribed antibiotics in 60 percent of visits for sore throats and 73 percent of visits for acute bronchitis. The antibiotic prescribing rate should be about 10 percent for sore throats and nearly zero for acute bronchitis.
The sore throat analysis is being published in JAMA Internal Medicine, available online today.
While antibiotic stewardship programs have helped reduce the misuse of the the medications in hospitals, the analyses suggest the message isn't reaching the community, with patients continuing to request antibiotics for conditions they don't cure, and doctors prescribing them. The inappropriate use of antibiotics adds to the creation of drug-resistant bacteria, or "superbugs," which are very difficult to treat and are a public health threat.
"Also, people need to understand that by taking antibiotics for viral infections, they're putting something in their bodies that they don't need," said Jeffrey A. Linder, MD, MPH, associate professor of medicine at Harvard Medical School, associate physician at Brigham & Women's Hospital, Boston, and senior author of the study. "Taking antibiotics unnecessarily exposes people to adverse drug reactions, allergies, yeast infections and nausea, with no benefit."
Sore throats caused by streptococcus bacteria ("strep") should be treated with antibiotics. But while people often think they have "strep" throat, streptococcus is the cause only about 10 percent of the time. In most cases, a virus causes the sore throat. Acute bronchitis is almost always viral, and even when bacteria are involved, there is no need for antibiotics unless the patient develops pneumonia, said Dr. Linder.