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Antibiotics Are Prescribed Too Often, But It's Not Easy To Tell When They Are Needed

​​​​​ For Release:  September 15, 2014

As many as 11.4 million antibiotic prescriptions written each year for children and teens may be unnecessary, according to a study in the October 2014 issue of Pediatrics, “Bacterial Prevalence and Antimicrobial Prescribing Trends for Acute Respiratory Tract Infections,” published online Sept. 15. Some respiratory infections are viral, which means they won’t be helped by antibiotics. Yet antimicrobial drugs are sometimes prescribed for these viral infections. Researchers did a meta-analysis of studies from 2000 to 2011 that looked at acute respiratory tract infection (ARTI) bacterial prevalence rates. They also analyzed data on children age 18 and younger who were evaluated in ambulatory clinics from 2000 to 2010 to determine estimated antibiotic prescribing rates. Based on the prevalence of bacteria in ear and throat infections, and considering that pneumococcal vaccine is now preventing many bacterial infections, the researchers estimated that 27.4 percent of U.S. children with ARTI have bacterial illness. (This estimate is for infections of the ear, sinus area, throat, or upper respiratory system.) Yet antibiotics are prescribed for about 56.95 percent of ARTI visits. Currently there are no practical tools for clinicians to use to distinguish viral from bacterial illness, other than the rapid strep test for throat infections. The authors note that such tools are urgently needed and, in the meantime, doctors may add this knowledge of bacterial prevalence as a point in their decision-making and in discussing watch-and-wait strategies or other approaches with families.


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