antibiotic resistance

Researchers in the US investigated the incidence of antibiotic over-prescription for several viral infections, which may lead to bacterial resistance.

Upper respiratory tract infection, acute bronchitis, and bronchiolitis are common viruses that can be treated without the use of antibiotics. In spite of clear guidelines around the treatment of these viral diseases, the problem of prescribing antibiotics unnecessarily to these patients is still extremely high. In the past recent years, 47 million unnecessary antibiotic prescriptions were given to patients. The negative consequence of this kind of over-prescribing of antibiotics is antibiotic resistance.

Antibiotic resistance occurs when, partially due to repeated exposure, antibiotics are no longer effective against certain strains of bacteria. Multi-drug resistance describes bacteria that are resistant to more than one antibiotic.

Global health concerns of antibiotic resistance

The rise of multi-drug resistance has raised concerns over the globe for the treatment of harmful infections. Some medical conditions, such as the respiratory disease tuberculosis, can no longer be treated using standard antibiotics. Mutations in the bacteria have developed that allow the bacteria to withstand treatment with standard antibiotics. Stronger antibiotics are now required to treat tuberculosis. This is dangerous in areas where the transmission of tuberculosis is rampant. However, the availability of antibiotics is not.

These findings compelled researchers Monica Schmidt, Melanie Spencer, and Lisa Davidson to conduct a study using data provided by the Carolina HealthCare System urgent care, family medicine, internal medicine, and paediatric practices. This study was published in a recent edition of the journal Infection Control and Hospital Epidemiology. The data provided by these clinics for this study included 448,990 visits between the months of January 2014 and May 2016, where these outpatient visits were for the common respiratory conditions that do not require antibiotics.

Antibiotics overprescribed by doctors

The results of the study showed that the healthcare providers prescribed antibiotics 407 times out of 1,000 visits. The number is exceptionally high since antibiotics are not recommended for these infections. The rate of prescribing antibiotics was increased by an additional 15% when adult patients were further referred to advanced practice practitioners by the family physicians. Furthermore, the results showed that older doctors were four times more likely than younger doctors to prescribe antibiotics to children with viral infections.

Through these findings, the researchers concluded that patients, health practitioners, and certain clinical practices are responsible for the prescription of unnecessary antibiotics. These unnecessary prescriptions are doing more harm than good, and research must be done to determine which factors that perpetuate the problem and areas of potential improvement. Adequate training and resources are crucial for patients and health practitioners.

Written by Dr. Apollina Sharma, MBBS, GradDip EXMD

Reference: Schmidt, M. L., Spencer, M. D., & Davidson, L. E. (2018). Patient, Provider, and Practice Characteristics Associated with Inappropriate Antimicrobial Prescribing in Ambulatory Practices. Infection Control & Hospital Epidemiology, 1-9.

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