This article from this month's JABFP reminds us that oversee of antibiotics remains a terrible problem in primary care, and family medicine especially. The rate of antibiotic prescription for URIs decreased from 52.1% in 1997 to 41.5% in 1999:
Conclusions: Despite a downward trend in antibiotic prescribing over the years, over-prescription of antibiotics for upper respiratory infections persists. General internal medicine physicians are less likely than general/family physicians to prescribe antibiotics, but this gap seems to be narrowing. Specific interventions must be designed to address these disparities.
Family physicians prescribed antibiotics 42.9% of the time for URI .. while Internists did so 36.2% of the time. Neither of these numbers is even approaching a reasonable goal (0%) … I think that it's obvious that family physicians need to be better educated on this perils of over-prescribing antibiotics and given the tools to treat patients appropriately. Of course, the CDC has some great educational tools .. but many states are working on this as well … and the google directory on antibiotic resistance is a good place to start looking for more information on this important topic.
6 thoughts on “Antibiotic Prescribing – Still too much”
I am curious as to why you say that zero percent is desirable.
Because antibiotics should not be prescribed for upper respiratory infections – which are almost always viral and self – limiting. To quote the article:
“Despite overwhelming evidence that overuse of antibiotics is detrimental, that most URIs are cured without treatment, and therefore that the lowest antibiotic prescription rates should be desirable”
What’s the lowest rate? 0%. I suppose that there may be some situations in which abx may be indicated .. so perhaps I’m being a nut about this … but a MINIMALIST nut (like me) probably balances the over-use a tiny bit.
I will start believing the CDC is worried about antibiotic resistance when herds of cattle and chicken stop being fed fluoroquinolones or other antibiotics daily.
The largest reservoir of potentially dangerously resistant bacteria could easily be coming from this source, yet the media and medical journals spend vast quantities of time tut-tutting about someone getting amoxicillin for 10 days.
If the CDC is concerned about resistance, shouldn’t we be discussing the practice of feeding fluoroquinolones and other broad-spectrum antibiotics to cattle and poultry in their daily feed?
This seems far more dangerous a practice than URI treatment with amoxicillin.
I will decide the CDC is serious about antibiotic resistance when they talk about antibiotics going to cattle and poultry daily.
It strikes me as much riskier than antibiotics for URI’s. That being said, what is the definition being used for URI?
sorry about the post flood, I could never see that my post was being posted. Must be some sort of bug.
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