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Antibiotics given too often for sore throat

Doctors often improperly prescribe antibiotics to children complaining of sore throats but could avoid that mistake by administering a simple test for strep throat, a study said.
/ Source: Reuters

Doctors often improperly prescribe antibiotics to children complaining of sore throats but could avoid that mistake by administering a simple test for strep throat, a study said.

American physicians prescribe antibiotics for 53 percent of the estimated 7.3 million children with sore throats who visit a doctor each year, the eight-year study said.

But antibiotics are called for in just the 15 percent to 36 percent of cases where the source of the pain and inflammation is strep throat, or group A streptococcal pharyngitis, against which antibiotics are effective.

“Children with sore throat are frequently given unnecessary antibiotics,” said study author Dr. Jeffrey Linder of Brigham and Women’s Hospital and Harvard Medical School. “This over-prescribing of antibiotics could be easily remedied by following known guidelines, which include doing a simple, inexpensive strep test before giving antibiotics.”

About half the children prescribed drugs did not undergo a test for strep.

“Strep testing is underused,” Linder said. “Instead of writing a prescription, physicians should order a test and make sure they are treating kids’ symptoms by offering a pain medication like acetaminophen or ibuprofen.”

Drug-resistant strains
The U.S. Centers for Disease Control and Prevention and the American Academy of Pediatrics both recommend the strep throat test before giving antibiotics to a child with a sore throat.

“This is critical for not just children but all patients as unnecessary prescription of antibiotics can lead to a variety of issues including increased costs, the potential development of antibiotic-resistant bacteria and adverse drug effects,” said Linder, who reported his findings in this week’s issue of the Journal of the American Medical Association.

Excessive use of antibiotics, especially in cases of viral illness against which antibiotics are ineffective, has been blamed for accelerating the development of drug-resistant strains of bacteria.

In addition, the study found antibiotics not recommended for use against strep throat were prescribed for 27 percent of the children who received drugs. Penicillin, amoxicillin, erythromycin and first-generation cephalosporins are considered effective against strep, the report said.

The message did appear to be getting through to some doctors, based on a favorable trend in the study showing antibiotic prescriptions declined to 54 percent of childhood sore throat cases in 2003 from 66 percent in 1995.

However, there was no decline in the prescribing of non-recommended antibiotics to children, who ranged in age from 3 to 17.