Doctors and Patients Start to Curb Use of Antibiotics
by Lawrence K. Altman
Originally printed in The New York Times, March 4, 2004.
Reprinted with permission.
Atlanta, March 3 — Doctors and patients are beginning to curb their use of antibiotics as a result of educational programs, federal health officials said Wednesday.
The inappropriate use of antibiotics has led illness-causing microbes to become resistant to such drugs. Antibiotic resistance is a major public health problem throughout the world and is particularly common among the bacteria that cause ear and respiratory infections.
"We are making progress" against the problem in this country, said Dr. Richard E. Besser, an epidemiologist at the Centers for Disease Control and Prevention. "When we look at the prescribing data across the nation, we see dramatic declines in prescriptions to children and to adults."
Further declines are likely after pediatric and family practice organizations issue new guidelines this spring that will encourage doctors to avoid prescribing antibiotics for ear infections in children, Dr. Besser said at the Fourth International Conference on Emerging Infections here.
The proposed guidelines, Dr. Besser said, emphasize the need for doctors to use stricter criteria in diagnosing infections and to relieve the pain that makes many children with ear infections cranky. The guidelines also advise doctors that observing children without prescribing antibiotics is acceptable therapy. Experience in Europe shows that 80 percent of children get better without the drugs, Dr. Besser said.
Antibiotics are most often prescribed for an inner ear infection known as otitis media, Dr. Besser said. In 1999 and in 2000, doctors in this country wrote an average of 11 million antibiotic prescriptions for ear infections in patients 15 and younger, a spokeswoman for the disease centers said.
From 1980 through 1982, the antibiotic prescribing rates for children among office-based doctors increased by 48 percent. But one study that Dr. Besser's team conducted showed about a 25 percent reduction, largely among office-based doctors, in the prescriptions for standard antibiotics for ear infections among children. The team expressed concern, however, that further studies might find that increased prescribing for newer antibiotics has offset the gains.
The centers and other health organizations have been conducting educational programs intended to correct misconceptions among doctors and the public about antibiotic therapy.
