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Study: Kids Prescribed Antibiotics Twice as Often as Needed

More than 11 million prescriptions may be unnecessary

Pediatricians prescribe antibiotics about twice as often as they’re actually needed for children with ear and throat infections, a new study indicates. The findings were published online September 15 in Pediatrics.

Researchers at the University of Washington performed a meta-analysis of English-language pediatric studies published between 2000 and 2011 to determine the bacterial prevalence rates of five acute respiratory-tract infections (ARTIs): acute otitis media (AOM), sinusitis, bronchitis, upper respiratory-tract infection (URI), and pharyngitis.

The investigators also conducted a retrospective cohort analysis of children aged less than 18 years who were evaluated in ambulatory clinics sampled by the 2000–2010 National Ambulatory Medical Care Survey (NAMCS) to determine the estimated U.S. ARTI antimicrobial prescribing rates.

In the meta-analysis, the AOM bacterial prevalence was 64.7%; Streptococcus pyogenes prevalence during pharyngitis was 20.2%. No URI or bronchitis studies and one sinusitis study met the inclusion criteria, identifying bacteria in 78% of subjects.

Based on these condition-specific bacterial prevalence rates, the expected antimicrobial prescribing rate for ARTI overall was 27.4%. However, the authors found that antimicrobial agents were prescribed in NAMCS during 56.9% of ARTI encounters, representing an estimated 11.4 million potentially preventable antimicrobial prescriptions annually.

“I think it’s well-known that we prescribers overprescribe antibiotics, and our intent was to put a number on how often we’re doing that,” said lead author Dr. Matthew Kronman. “But as we found out, there’s really been no change in this [situation] over the last decade.”

A rapid strep test is currently available to distinguish between bacterial or viral throat infections. But other than that test, physicians have no clinical tools to tell the cause of most URIs, according to background information in the study.

Sources: Medical Xpress; September 15, 2014; and Pediatrics; September 15, 2014.

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