CDC: Millions of antibiotic prescriptions each year are unnecessary
At least 30 percent of antibiotics are unnecessarily prescribed, contributing to the rise of debilitating and sometimes deadly bacteria-resistant superbugs, according to a study released Tuesday.
To reach this conclusion, researchers tracked antibiotic use in doctors' offices and emergency departments between 2010 and 2011 throughout the United States. The study results were published in Journal of the American Medical Association by the Centers for Disease Control and Prevention along with Pew Charitable Trusts.
The findings showed that doctors needlessly wrote prescriptions for viruses, such as the common cold, viral sore throats and other ailments that can't be cured with antibiotics. More than 47 million excess prescriptions put patients in harm's way for allergic reactions and superbugs, such as clostridium difficile, or C. Diff.
“The rampant misuse of antibiotics is probably the leading infectious disease public health threat the world faces,” Dr. Amesh Adalja, a UPMC infectious disease specialist, said after learning of the study results. “The spread of antimicrobial-resistant bacteria and the infections they cause are a crisis and, if allowed to continue, will drag civilization back decades.”
Superbugs kill 23,000 Americans a year and sicken 2 million, according to the CDC.
When doctors unnecessarily prescribe antibiotics for a viral infection, they're essentially destroying beneficial bacteria needed to protect against infections like C. Diff, which causes colon inflammation and severe diarrhea. C. Diff infects half a million Americans a year, according to the CDC.
Unnecessary antibiotic use also promotes the evolution of drug-resistant strains of bacteria that cause other ailments.
During the study period, the annual antibiotic prescription rate was 506 per 1,000 people, but only 353 of the prescriptions were found to be necessary. About 13 percent of all outpatient visits in the United States, or 154 million visits annually, lead to an antibiotic prescription, according to the study.
In general, doctors preach the need for patients to be patient when they complain of coughs, runny noses and other flu-like symptoms, said Dr. Marc Itskowitz, an internal medicine physician at Allegheny General Hospital. The problem, he said, is that many patients want instant relief in the form of a prescription.
“It can be hard to take a study like this and use it in clinical practice,” Itskowitz said. “There is a concern toward meeting patient expectations, which is part of the challenge.”
Still, he said, it's important for doctors and patients to understand the formal statistics in the JAMA study.
“This requires buy-in from the patient that, in many cases, he or she is going to get better without antibiotics,” he said. “Resistant bacteria is a major concern.”
The study recommended that doctors and patients more frequently discuss when antibiotics are required.
“Antibiotics are lifesaving drugs, and if we continue down the road of inappropriate use we'll lose the most powerful tool we have to fight life-threatening infections,” said CDC Director Tom Frieden. “Losing these antibiotics would undermine our ability to treat patients with deadly infections, cancer, provide organ transplants and save victims of burns and trauma.”
Last year, the White House set its sights on superbugs, releasing a plan to combat the proliferation of antibiotic-resistant bacteria. The plan's goal is to reduce outpatient antibiotic use by 50 percent and inpatient use by 20 percent by 2020.
“The value of antibiotics to humans is almost incalculable,” Adalja said. “The public — including injudicious physician antibiotic prescribers — must come to realize that they are part of the problem and they should not employ antibiotics unless absolutely necessary.”
Ben Schmitt is a Tribune-Review staff writer.