Unnecessary Antibiotics Still Prescribed on Daily Basis

A new study reveals that half of seniors presenting to a primary care physician with symptoms of viral infections were erroneously given an antibiotic prescription.

Researchers at the Institute for Clinical Evaluative Sciences, Royal Victoria Hospital, and other institutions conducted a retrospective analysis of linked administrative health care data in order to determine the prevalence of antibiotic prescribing for nonbacterial acute upper respiratory infection (AURI) among primary care physician practices in the province of Ontario (Canada) between January and December 2012.

The study included 8,990 primary care physicians and 185,014 low-risk seniors (65 years and older) who were treated by them while suffering from a non-bacterial AURI such as the common cold (53.4%), acute bronchitis (31.3%), acute sinusitis (13.6%), or acute laryngitis (1.6%). Excluded from the study were patients with cancer or immunosuppressive conditions and residents of long-term care homes.

The results showed that 85,538 (46%) of the patients received an antibiotic prescription, with most prescriptions being for broad-spectrum agents. A breakdown of the results showed that patients were more likely to receive prescriptions from mid- and late-career physicians than early-career physicians, from physicians trained outside of Canada or the United States, and from physicians who saw 25-44 patients per day or 45 or more patients per day, as compared to those that saw fewer than 25 patients per day. The study was published on May 9, 2017, in Annals of Internal Medicine.

“Our study shows that antibiotics are being prescribed too often for conditions that they cannot help, despite published professional guidelines that discourage this practice. Unnecessary antibiotics can cause serious harm, said lead author Michael Silverman, MD, of ICES. “Reducing inappropriate antibiotic prescribing for acute upper respiratory tract infections requires a better understanding of the factors associated with this practice.”

The findings of the study concur with other research suggesting that physician preference appears to be “the driver in overuse of antibiotics, which may or may not reflect the individual needs of patients, and the concomitant rise in antibiotic resistance. The problem is aggravated by economic and social barriers to rational use of drugs, for example in hospitals that derive revenue from medication sales. Other major drivers of antibiotic resistance include self-medication, lack of education, patient non-compliance, misinformation, and advertising pressures.