Antibiotic Misuse: Dangerous for Everyone

For certain patients who develop bacterial infections, antibiotics are remarkably effective drugs, relieving suffering and saving lives. But when health care providers prescribe antibiotics to patients who do not need them, these drugs endanger both the patients taking them and the public at large.

For such patients, there is only the possibility for harm from adverse effects — some potentially life-threatening — without any prospect of benefit. And for the rest of us, overprescribing of antibiotics contributes to the development of antibiotic-resistant bacteria, a growing global public health threat. As more and more types of bacteria develop resistance to today’s antibiotics, the ability to treat infectious diseases is compromised.

In a 2013 report highlighting the dangers posed by antibiotic-resistant infections, the Centers for Disease Control and Prevention (CDC) estimated that such infections cause at least 2 million illnesses and 23,000 deaths annually in the U.S.[1]

Unfortunately, the results of a recent study published in the Journal of the American Medical Association (JAMA) reveal a disturbing picture of the extent of antibiotic misuse. For the study, a CDC-led team of researchers determined how often oral antibiotics are prescribed in the U.S. in the outpatient setting (including emergency room visits) and what proportion of these prescriptions are inappropriate.[2]

Using data from two large national annual surveys of outpatient medical care for 2010 and 2011, the researchers found that patients were prescribed antibiotics in approximately 13 percent of all outpatient visits. Approximately 154 million antibiotic prescriptions were written in each of these two years. Nearly one-third of all antibiotic prescriptions were considered inappropriate. For patients age 65 and older, nearly one-fifth of such prescriptions were estimated to be inappropriate.

Reducing the misuse of antibiotics in patient care is a global priority. Addressing the problem requires action by health care providers and patients alike. Both must understand that antibiotics are a precious, and ultimately limited, resource that must be used judiciously.

Patients should not pressure their health care providers to prescribe antibiotics for symptoms that are likely due to viral illnesses — such as colds and most cases of sore throat and bronchitis. Likewise, health care providers must resist patient demands for antibiotics when they are not necessary and, instead, counsel patients on the dangers of inappropriate antibiotic use. Through these and other actions, patients can avoid direct serious harm caused by the unnecessary use of antibiotics, and the broader threat to everyone posed by antibiotic-resistant bacteria can be reduced.

References

[1] Centers for Disease Control and Prevention. Antibiotic Resistance Threats in the United States, 2013. http://www.cdc.gov/drugresistance/threat-report-2013/pdf/ar-threats-2013-508.pdf. Accessed May 21, 2016.

[2] Fleming-Dutra KE, Hersh AL, Shapiro DJ, et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011. JAMA. 2016;315(17):1864-1873.