Don’t ask your pediatrician for an antibiotic if you child has an ear infection, sore throat or cough. Chances are he doesn’t need it, according to a recent study released by the American Academy of Pediatrics.
Nationally, the prescription of antibiotics for acute respiratory tract infections is twice the rate expected based on the prevalence of bacteria, according to the study in the October 2014 issue of Pediatrics, titled “Bacterial Prevalence and Antimicrobial Prescribing Trends for Acute Respiratory Tract Infections.” As many as 11.4 million antibiotic prescriptions written each year for children and teens may be unnecessary, the study stated.
Some respiratory infections are viral, which means antibiotics don’t help them. Yet antimicrobial drugs (which include antibiotics) are sometimes prescribed for these viral infections. Researchers did an analysis from 2000 to 2011 that looked at how many acute respiratory tract infections were bacterial. They also analyzed data on children age 18 and younger who were evaluated in ambulatory clinics from 2000 to 2010 to determine how often antibiotics were prescribed.
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 about 27 percent of U.S. children with an earache, sinus problem, sore throat or upper respiratory issues have a bacterial illness. Yet antibiotics are prescribed for about 57 percent of the cases, the study determined.
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 study stated. The authors noted that such tools are urgently needed. In the meantime, doctors should consider the knowledge of bacterial prevalence when deciding whether to prescribe antibiotics and in discussing watch-and-wait strategies or other approaches with families.
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