Antibiotics continue to be unreasonably prescribed often for sore throat and acute bronchitis
For sore throats, doctors prescribe antibiotics 6 times more often than they really need and continue to prescribe antibiotics for acute bronchitis, although there is no evidence of the benefits of using them .
As the results of two new studies have shown, with a sore throat, doctors prescribe antibiotics 6 times more often than they really need and continue to prescribe antibiotics for acute bronchitis, although there is no evidence of the benefits of their use.
Efforts to reduce the unreasonable prescription of antibiotics for sore throats have had only a moderate effect, while they have not been shown to be effective in acute bronchitis - these data were presented by scientists from the Harvard Medical School (Harvard Medical School, Boston, United States).
The results of 2 studies on the frequency of antibiotic use for sore throat and bronchitis, presented in October at IDWeek 2013, indicate that doctors are still far from practicing the reasonable use of antibiotics.
An analysis of antibiotic prescribing for sore throats was published in the October online issue of JAMA Internal Medicine. To assess the effectiveness of efforts to reduce the unreasonable prescription of antibiotics for sore throats, the researchers analyzed national databases that included information on the use of antibiotics in ambulatory and hospital settings (National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey).
It turned out that during the period from 1997 to 2010, a total of 94 million complaints were registered concerning sore throats with primary care doctors and emergency services. Doctors prescribed antibiotics in 60% of sore throats and 73% of cases of acute bronchitis, while the frequency of antibiotics for acute tonsillitis should be around 10% and antibiotics should not be used for acute bronchitis.
Errors in medical tactics for acute tonsillitis were not just about the abnormally frequent use of antibiotics - doctors generally chose the wrong drugs for the treatment of this nosological form. Many doctors have prescribed new antibiotics to which, however, Streptococcus pyogenes was already resistant, regardless of the 100% sensitivity of pyogenic streptococcus to "old" penicillin. Thus, only in 9% of doctor's visits to sore throats, penicillin was prescribed, and this ratio did not change over the 13-year study period. The frequency of use of azithromycin in acute tonsillitis increased from 5% to 15%.
This is not to say that efforts to reduce the unreasonable use of antibiotics for sore throats have been in vain - there is still little progress. Thus, antibiotics were used in this nosological form in 80% of cases in 1990 and in 70% in 2000, but since 2000 no positive dynamics have been noted, so this improvement can be considered minimal.
During the study period, a decrease in the frequency of medical requests for sore throat was recorded (7.5% of all visits in 1997 and 4.5% in 2010, p = 0.006).
As for acute bronchitis, the situation is as follows. In 1996, 1.1 million requests for bronchitis were reported to primary care physicians and emergency departments, and in 2010, 3.4 million requests. In the vast majority of cases, acute bronchitis is a viral infection and antibiotics are not necessary. The duration of the disease is usually around 3 weeks, but most patients seek medical assistance on the 5-8th day. Doctors prescribe antibiotics at the request of patients. If the doctor takes only a few minutes to explain to the patient why antibiotics for acute bronchitis can do more harm than good, the patient will leave satisfied to speak to the doctor and will not need antibiotics.