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 recent 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."
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.
Reference
Source 89
November
9, 2005
