Antibiotic Overuse Continuing, Despite Health Concerns: Study

Although experts have expressed concern for years about the use of antibiotics and the health risks posed by the emergence of antibiotic resistant strains of bacteria, new research suggests that antibiotic overuse remains a problem in many emergency rooms. 

In a study recently published ahead of print by the medical journal Antimicrobial Agents and Chemotherapy, researchers from the University of Alabama indicate that the inappropriate use of antibiotics for adult patients increased over a ten year time period. However, the study notes that there was a decrease in inappropriate antibiotic prescriptions for children during the same time frame.

Researchers examined data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2001 to 2010, using more than 126 million emergency room visits with diagnoses for acute respiratory tract infections (ARTIs).

The retrospective cohort study focused on antibiotic appropriate uses of the medication for infections like sinusitis, tonsillitis and non-viral pneumonia. Researchers also looked at data including the prescription of antibiotics for inappropriate cases, such as viral pneumonia, bronchitis, unspecified respiratory tract infections and influenza. Of the cases examined, antibiotics were prescribed for 61% of cases.

John Donnelly, M.D., and his team of researchers found inappropriate antibiotic use for pediatric patients under the age of 19 years old decreased significantly. However, antibiotic use for inappropriate cases increased drastically in adult patients. Researchers noted the occurrence increased from 83 instances per 1,000 visits to 105 cases in 1,000 visits during that time.

“The proportion of adult ARTI patients receiving antibiotics in US EDs is inappropriately high,” the study’s authors wrote.

Antibiotics have no effectiveness against viral infections, only for bacterial infections. However, patients continue to push for antibiotics hoping for a quick fix. Experts say that overuse of antibiotics, or incomplete use when they are appropriately prescribed is contributing to the increase in the occurrence of antibiotic resistant strains of bacteria.

Many hospitals have begun to implement antibiotic stewardship efforts. The increase in cases of inappropriate use may also be a consequence of the difficulty of making definitive diagnoses in certain respiratory infections in an emergency room setting.

Despite those issues, researchers say that measures to reduce inappropriate antibiotic use in emergency room settings is warranted and should focus on increased education among health care providers; especially considering that respiratory infections make up one-tenth of all ambulatory care visits in the emergency room.

The findings of the new study come on the heels of research reported in JAMA Internal Medicine in October 2013, which found that doctors continue to misuse and overprescribe antibiotics. That research indicated that doctors in the U.S. have a tendency to prescribe antibiotics six out of every 10 times a patient complains of a sore throat, even though antibiotics are typically only necessary or warranted in one of of those 10 cases.