Doctors continue to prescribe unnecessary antibiotics for bronchitis

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After decades of research, experts have found that may doctors continue to prescribe antibiotics for viral infections they cannot help, such as the common cold.

While health officials with the U.S. Centers for Disease Control and Prevention (CDC) are attempting to lower antibiotic prescribing rates, a new report from the Journal of the American Medical Association shows that about 70 percent of patients with acute bronchitis still receive antibiotics.

Acute bronchitis—a deep cough often accompanied by phlegm that typically lasts for a few weeks—is caused by a virus. Because antibiotics only kill bacteria, they are completely ineffective against viral infections.

The overuse of antibiotics in humans and animals has given rise to drug-resistant bacteria. According to the CDC, these “superbugs” affect two million Americans every year, killing at least 23,000.

Unnecessary Antibiotics for Acute Bronchitis

Acute bronchitis is one of the top 10 conditions for which people see a doctor.

Researchers with Brigham and Women's Hospital in Boston studied prescription rates for acute bronchitis from 1996 to 2010 using data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey.

Using 3,153 sampled acute bronchitis visits to physicians, outpatient clinics, and emergency rooms, researchers found that doctors prescribed antibiotics in 71 percent of all cases. The prescribing rate increased during the 15-year study period.

Between 1980 and 1999, antibiotic use for acute bronchitis was 60 to 80 percent in the U.S.

The largest increase in prescriptions in the latest sample was for patients in emergency rooms, the researchers said.

Since 2005, the Healthcare Effectiveness Data and Information Set (HEDIS) states that absolutely no antibiotics should be given to patients with acute bronchitis.

“Avoidance of antibiotic overuse for acute bronchitis should be a cornerstone of quality health care. Antibiotic overuse for acute bronchitis is straightforward to measure. Physicians, health systems, payers, and patients should collaborate to create more accountability and decrease antibiotic overuse,” the researchers concluded.

The Importance of Judicious Antibiotic Use

The overuse of antibiotics has become a concern across the globe.

The World Health Organization recently reported that antibiotic resistance is a “serious threat... no longer a prediction for the future, it is happening right now in every region of the world and has the potential to affect anyone, of any age, in any country.” They suggest that doctors only dispense antibiotics when they are truly needed, and prescribe the right antibiotics to a specific illness.

The U.S. ranks fifth for overall antibiotic prescriptions in the world. Kentucky, West Virginia, Tennessee, Mississippi, and Louisiana have the highest prescription rates in the country, according to the Center for Disease Dynamics, Economics, and Policy.

A CDC report released in March found that doctors’ prescribing practices vary widely across the U.S., despite caring for patients with similar needs. As many as a third of patients with routine urinary tract infections are given vancomycin, a common and critical antibiotic, without screening for bacteria. And many are given the antibiotic for too long.